Basic Information
| Provider Information | |||||||||
| NPI: | 1083656458 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | HAWKINS & HAWKINS, PA | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | HAWKINS MEDICAL ASSOCIATES | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 25 FIRST PARK DR | ||||||||
| Address2: | SUITE A | ||||||||
| City: | OAKLAND | ||||||||
| State: | ME | ||||||||
| PostalCode: | 049635361 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2078734325 | ||||||||
| FaxNumber: | 2078734344 | ||||||||
| Practice Location | |||||||||
| Address1: | 25 FIRST PARK DR | ||||||||
| Address2: | SUITE A | ||||||||
| City: | OAKLAND | ||||||||
| State: | ME | ||||||||
| PostalCode: | 049635361 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2078734325 | ||||||||
| FaxNumber: | 2078734344 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/12/2006 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | HAWKINS | ||||||||
| AuthorizedOfficialFirstName: | TRACY | ||||||||
| AuthorizedOfficialMiddleName: | BANSIDHAR | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 2078734325 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
| AuthorizedOfficialNameSuffix: | |||||||||
| AuthorizedOfficialCredential: | D.O. | ||||||||
| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.