Healthcare Provider Details

I. General information

NPI: 1295933224
Provider Name (Legal Business Name): JAMES M HAWK, M.D.,P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/11/2007
Last Update Date: 03/26/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

303 W NEWMAN AVE
HARRISON AR
72601-5839
US

IV. Provider business mailing address

PO BOX 392
HARRISON AR
72602-0392
US

V. Phone/Fax

Practice location:
  • Phone: 870-741-4295
  • Fax: 870-741-6569
Mailing address:
  • Phone: 870-741-4295
  • Fax: 870-741-6569

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberE2493
License Number StateAR

VIII. Authorized Official

Name: KIMBERLY LYNN GREENLEE
Title or Position: OFFICE MANAGER
Credential:
Phone: 870-741-4295