Healthcare Provider Details

I. General information

NPI: 1891019576
Provider Name (Legal Business Name): EDWARD S HAWKINS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/24/2010
Last Update Date: 03/18/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 E WASHINGTON ST MEDINA GENERAL HOSPITAL EMERGENCY DEPT
MEDINA OH
44256-2170
US

IV. Provider business mailing address

PO BOX 30790 MEDINA EMERGENCY ASSOCIATES LTD
MIDDLEBURG HEIGHTS OH
44130-0790
US

V. Phone/Fax

Practice location:
  • Phone: 330-725-1000
  • Fax: 330-654-9086
Mailing address:
  • Phone: 330-654-1185
  • Fax: 330-654-9086

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number121337
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: