Healthcare Provider Details

I. General information

NPI: 1275946162
Provider Name (Legal Business Name): JAMES HAWLEY NP-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/09/2014
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

178 HIGHWAY 24 STE A
CENTREVILLE MS
39631-4217
US

IV. Provider business mailing address

178 HIGHWAY 24 STE A
CENTREVILLE MS
39631-4217
US

V. Phone/Fax

Practice location:
  • Phone: 601-890-0520
  • Fax: 601-645-5088
Mailing address:
  • Phone: 601-890-0520
  • Fax: 601-645-5088

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR879421
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: