1952382731 NPI number — DR. JAMES R HAWKINS M.D.

Table of content: DR. JAMES R HAWKINS M.D. (NPI 1952382731)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1952382731 NPI number — DR. JAMES R HAWKINS M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HAWKINS
Provider First Name:
JAMES
Provider Middle Name:
R
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1952382731
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/08/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2727 MADISON RD
Provider Second Line Business Mailing Address:
SUITE 303B
Provider Business Mailing Address City Name:
CINCINNATI
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
45209-2276
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
513-721-0990
Provider Business Mailing Address Fax Number:
513-721-5313

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2727 MADISON RD
Provider Second Line Business Practice Location Address:
SUITE 303B
Provider Business Practice Location Address City Name:
CINCINNATI
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
45209-2276
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
513-721-0990
Provider Business Practice Location Address Fax Number:
513-721-5313
Provider Enumeration Date:
11/09/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 174400000X , with the licence number:  34138 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2084P0800X , with the licence number: 34138 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0195506 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 64783343 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0203569 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 260006409 . This is a "RR MEDICARE INDIVIDUAL" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: DH1300 . This is a "RR MEDICARE GROUP" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".




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