Basic Information
| Provider Information | |||||||||
| NPI: | 1871604827 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HAWKINS | ||||||||
| FirstName: | DAVID | ||||||||
| MiddleName: | MICHAEL | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | DO | ||||||||
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| Mailing Information | |||||||||
| Address1: | 408 MIDDLETON DR | ||||||||
| Address2: | |||||||||
| City: | ASHLAND | ||||||||
| State: | MO | ||||||||
| PostalCode: | 650109876 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3086750204 | ||||||||
| FaxNumber: | 3086750204 | ||||||||
| Practice Location | |||||||||
| Address1: | 1445 CHRISTY DR | ||||||||
| Address2: | |||||||||
| City: | JEFFERSON CITY | ||||||||
| State: | MO | ||||||||
| PostalCode: | 651012853 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5736363483 | ||||||||
| FaxNumber: | 5736367716 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/31/2006 | ||||||||
| LastUpdateDate: | 08/25/2010 | ||||||||
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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 | 207L00000X | 2008004461 | MO | Y | Allopathic & Osteopathic Physicians | Anesthesiology | 207L00000X | 598 | NE | N | Allopathic & Osteopathic Physicians | Anesthesiology |
No ID Information.