Individual provider · Type 1 NPI

Jacob Ryan Hathaway, DO

Family Medicine Physician · Camp Lejeune, NC

NPI number 1265203277 Active

Practice location

100 Brewster Blvd
Camp Lejeune, NC 28547-2575

Call (910) 450-4357 Map

Mailing address

221 E Mallard Dr Apt 116
Boise, ID 83706-6603

Specialties and licenses

TaxonomyCodeLicense
Family Medicine Physician Primary 207Q00000X2025-03782 (NC)
Student in an Organized Health Care Education/Training Program 390200000XNone listed

Family Medicine Physician: Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

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About NPI 1265203277

Jacob Ryan Hathaway, DO's National Provider Identifier is 1265203277, issued on Jan 10, 2024. The primary taxonomy on file is Family Medicine Physician (207Q00000X), and the practice location is in Camp Lejeune, NC. The record was last updated on Oct 31, 2025.