Basic Information
| Provider Information | |||||||||
| NPI: | 1720245301 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HAWKINS | ||||||||
| FirstName: | CHRISTOPHER | ||||||||
| MiddleName: | HEATH MEYERS | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | P.O. BOX 409879 | ||||||||
| Address2: | |||||||||
| City: | ATLANTA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 30384 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6152616000 | ||||||||
| FaxNumber: | 6152616052 | ||||||||
| Practice Location | |||||||||
| Address1: | 5651 FRIST BLVD. | ||||||||
| Address2: | STE 616 | ||||||||
| City: | HERMITAGE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 37076 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6153914394 | ||||||||
| FaxNumber: | 6153910284 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/21/2008 | ||||||||
| LastUpdateDate: | 08/19/2008 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208800000X | 01060844A | IN | Y | Allopathic & Osteopathic Physicians | Urology |
ID Information
| ID | Type | State | Issuer | Description | 01060844A | 01 | IN | LICENSE | OTHER |