Healthcare Provider Details

I. General information

NPI: 1194982256
Provider Name (Legal Business Name): ELIZABETH S. HAWKINS DPM
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/16/2008
Last Update Date: 05/16/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7423 PICARDY AVE SUITE B
BATON ROUGE LA
70808-4362
US

IV. Provider business mailing address

7423 PICARDY AVE SUITE B
BATON ROUGE LA
70808-4362
US

V. Phone/Fax

Practice location:
  • Phone: 225-766-3955
  • Fax: 225-761-8833
Mailing address:
  • Phone: 225-766-3955
  • Fax: 225-761-8833

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP1100X
TaxonomyPodiatric Clinic/Center
License NumberPDO96R
License Number StateLA

VIII. Authorized Official

Name: ELIZABETH S. HAWKINS
Title or Position: PHYSICIAN
Credential: DPM
Phone: 225-766-3955