Healthcare Provider Details

I. General information

NPI: 1154310555
Provider Name (Legal Business Name): WILLIAM H HAWKINS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/18/2005
Last Update Date: 10/12/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6802 S OLYMPIA AVE W SUITE 200
TULSA OK
74132-1823
US

IV. Provider business mailing address

6802 S OLYMPIA AVE STE 200
TULSA OK
74132-1826
US

V. Phone/Fax

Practice location:
  • Phone: 918-749-8393
  • Fax: 918-747-3112
Mailing address:
  • Phone: 918-388-9090
  • Fax: 918-388-9093

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number19093
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: