Mallori Wisuri Hathaway, PA-C
NPI #1861019689 in Scottsburg, Indiana
Provider Information
- NPI Number
- 1861019689
- Entity Type
- Individual
- Name
- Mallori Wisuri Hathaway, PA-C
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Physician Assistant
- Credential
- PA-C
- Enumeration Date
- Jun 27, 2020
- Last Updated
- Nov 12, 2025
Practice Location
- Address
- 1428 N GARDNER ST
- City
- Scottsburg
- State
- Indiana
- ZIP Code
- 47170-8720
- Phone
- (812) 752-3512
Specialties & Taxonomy Codes
| Specialty |
|---|
| Physician Assistant |
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