Healthcare Provider Details

I. General information

NPI: 1982738472
Provider Name (Legal Business Name): JAMES HUBERT HAWKINS JR. MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/15/2007
Last Update Date: 06/25/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1205 S MAIN ST
GRAHAM NC
27253-4511
US

IV. Provider business mailing address

1205 S MAIN ST
GRAHAM NC
27253-4511
US

V. Phone/Fax

Practice location:
  • Phone: 336-570-0344
  • Fax:
Mailing address:
  • Phone: 336-570-0344
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number23847
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: