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NPI Code Detail

MEDICARE: JEFFERY K HAWKINS, MD, PLLC

MEDICARE: JEFFERY K HAWKINS, MD, PLLC
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
1207QS0010XSports Medicine (Family Medicine) Physician

General Provider Information

NPI Number : 1538778279
Entity Type Code : Organization
Provider Name (Legal Business Name) : JEFFERY K HAWKINS, MD, PLLC
Provider Business Mailing Address
First Line : 7148 TRAIL LAKE DR
Second Line :
City : FORT WORTH
State : TX
Zip : 76123-1969
Country : US
Telephone Number : 817-953-2968
Fax Number :
Provider Business Practice Location Address
First Line : 729 W BEDFORD EULESS RD STE 206
Second Line :
City : HURST
State : TX
Zip : 76053-3941
Country : US
Telephone Number : 817-294-0934
Fax Number : 817-294-1488
Authorized Official
Title or Position : BILLING MANAGER
Name : LORI A PAYNE
Credential :
Telephone Number : 817-953-2968
Provider Enumeration Date : 07/29/2020
Last Update Date : 07/29/2020

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Directions to “JEFFERY K HAWKINS, MD, PLLC ” Practice Location

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