Healthcare Provider Details

I. General information

NPI: 1619696796
Provider Name (Legal Business Name): SETH HAWKS PT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/23/2022
Last Update Date: 05/13/2026
Certification Date: 05/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7030 CANAL BLVD
NEW ORLEANS LA
70124-3410
US

IV. Provider business mailing address

PO BOX 9118
MINNEAPOLIS MN
55480-9118
US

V. Phone/Fax

Practice location:
  • Phone: 504-988-0100
  • Fax:
Mailing address:
  • Phone: 615-329-2294
  • Fax: 615-695-1494

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number14177
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code2251S0007X
TaxonomySports Physical Therapist
License Number12281R
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: