Healthcare Provider Details

I. General information

NPI: 1194810234
Provider Name (Legal Business Name): JAMES R HAWKINS MD & ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/04/2006
Last Update Date: 04/06/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2727 MADISON ROAD, SUITE 303B
CINCINNATI OH
45209
US

IV. Provider business mailing address

2727 MADISON ROAD, SUITE 303B
CINCINNATI OH
45209
US

V. Phone/Fax

Practice location:
  • Phone: 513-721-0990
  • Fax: 513-721-5313
Mailing address:
  • Phone: 513-721-0990
  • Fax: 513-721-5313

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number034138
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number034138
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code364SP0808X
TaxonomyPsychiatric/Mental Health Clinical Nurse Specialist
License NumberNS-03684
License Number StateOH
# 4
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberE0000762
License Number StateOH
# 5
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number34138
License Number StateOH

VIII. Authorized Official

Name: MS. SHARON A YOUNG
Title or Position: SECRETARY
Credential: M.D.
Phone: 513-721-0990