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General NPI Number Information
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NPI Number | 1043363716
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Entity Type | Individual
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Provider Name | THOMAS H HAWK JR. M.D.
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Gender | Male
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Dates
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Enumeration Date | 01/18/2007
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Last Update Date | 04/02/2014
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Provider Practice Location Address
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Address Line | 740 PRINCE AVE BUILDING 8A
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City | ATHENS
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State | GA
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Zip | 30606-5908
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Country | US
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Telephone | 706-353-1630
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Fax | 706-543-6825
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Provider Business Mailing Address
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Address Line | 740 PRINCE AVE BUILDING 8A
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City | ATHENS
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State | GA
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Zip | 30606-5908
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Country | US
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Telephone | 706-353-1630
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Fax | 706-543-6825
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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 | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 019390
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License Number State | GA
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