Healthcare Provider Details

I. General information

NPI: 1073587663
Provider Name (Legal Business Name): BRANDON JAMES HAWKINS DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/13/2006
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 NEW STINE RD
BAKERSFIELD CA
93309
US

IV. Provider business mailing address

110 NEW STINE RD
BAKERSFIELD CA
93309-2605
US

V. Phone/Fax

Practice location:
  • Phone: 661-832-1667
  • Fax: 661-832-7145
Mailing address:
  • Phone: 661-832-1667
  • Fax: 661-832-7145

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberE4648
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: