MEDICARE: DR. JEFFREY J HAWKINS M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208D00000X	General Practice Physician	93-281	NM

General Provider Information

NPI Number	:	1396704565
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JEFFREY J HAWKINS M.D.

Provider Business Mailing Address
First Line	:	73 PASEO DEL PAISANO
Second Line	:
City	:	SANTA FE
State	:	NM
Zip	:	87506-7984
Country	:	US
Telephone Number	:	505-988-1045
Fax Number	:	888-351-6207

Provider Business Practice Location Address
First Line	:	73 PASEO DEL PAISANO
Second Line	:
City	:	SANTA FE
State	:	NM
Zip	:	87506-7984
Country	:	US
Telephone Number	:	505-988-1045
Fax Number	:	888-351-6207

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/17/2006
Last Update Date	:	09/01/2009

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