MEDICARE: AFTER HOURS PEDIATRICS PC

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	208000000X	Pediatrics Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1588730360
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AFTER HOURS PEDIATRICS PC

Provider Business Mailing Address
First Line	:	9201 MONTGOMERY BLVD NE
Second Line	:	SUITE 201
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87111-2468
Country	:	US
Telephone Number	:	505-298-2505
Fax Number	:	505-298-2985

Provider Business Practice Location Address
First Line	:	9201 MONTGOMERY BLVD NE
Second Line	:	SUITE 201
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87111-2468
Country	:	US
Telephone Number	:	505-298-2505
Fax Number	:	505-298-2985

Authorized Official
Title or Position	:	PRESIDENT, CEO
Name	:	DR. WILLIAM B HAWK
Credential	:	M.D.
Telephone Number	:	505-298-2505

Provider Enumeration Date	:	11/25/2006
Last Update Date	:	08/22/2020

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