Healthcare Provider Details

I. General information

NPI: 1346274438
Provider Name (Legal Business Name): JAMES M HAWKINS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/11/2006
Last Update Date: 04/29/2024
Certification Date: 04/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

617 OLD SYMSONIA RD
BENTON KY
42025-5042
US

IV. Provider business mailing address

PO BOX 9150
PADUCAH KY
42002-9150
US

V. Phone/Fax

Practice location:
  • Phone: 270-339-5269
  • Fax: 270-527-8734
Mailing address:
  • Phone: 270-744-8413
  • Fax: 270-744-8642

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number19370
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: