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General NPI Number Information
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NPI Number | 1013249762
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Entity Type | Individual
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Provider Name | SUSAN STEVERSON HAWKINS D.M.D.
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Gender | Female
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Dates
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Enumeration Date | 02/05/2010
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Last Update Date | 04/12/2013
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Provider Practice Location Address
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Address Line | 1010 HARRISON AVE
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City | PANAMA CITY
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State | FL
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Zip | 32401-2429
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Country | US
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Telephone | 850-215-8052
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Fax | 850-215-8053
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Provider Business Mailing Address
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Address Line | 1010 HARRISON AVE
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City | PANAMA CITY
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State | FL
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Zip | 32401-2429
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Country | US
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Telephone | 850-215-8052
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Fax | 850-215-8053
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DN 17339
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License Number State | FL
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