Healthcare Provider Details

I. General information

NPI: 1912848409
Provider Name (Legal Business Name): KEVIN J HAWKINS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/01/2026
Last Update Date: 04/01/2026
Certification Date: 04/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2116 W M 55
WEST BRANCH MI
48661-9701
US

IV. Provider business mailing address

2116 W M 55
WEST BRANCH MI
48661-9701
US

V. Phone/Fax

Practice location:
  • Phone: 989-245-0246
  • Fax: 844-430-0203
Mailing address:
  • Phone: 989-245-0246
  • Fax: 844-430-0203

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: