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NPI Code Detail

MEDICARE: JONATHAN L HAWES PA

MEDICARE: JONATHAN L HAWES PA
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
1363AM0700XMedical Physician Assistant710IA

Other Identifiers

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

General Provider Information

NPI Number : 1720083363
Entity Type Code : Individual
Provider Name (Legal Business Name) : JONATHAN L HAWES PA
Provider Business Mailing Address
First Line : 40 1ST ST SE
Second Line :
City : WAUKON
State : IA
Zip : 52172-2022
Country : US
Telephone Number : 563-568-3411
Fax Number : 563-568-6139
Provider Business Practice Location Address
First Line : 40 1ST ST SE
Second Line :
City : WAUKON
State : IA
Zip : 52172-2022
Country : US
Telephone Number : 563-568-3411
Fax Number : 563-568-6139
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/20/2005
Last Update Date : 09/22/2020

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Directions to “ JONATHAN L HAWES PA” Practice Location

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