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General NPI Number Information
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NPI Number | 1144247693
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Entity Type | Individual
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Provider Name | JAMES HAWK MD
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Gender | Male
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Dates
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Enumeration Date | 07/17/2006
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Last Update Date | 06/17/2014
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Provider Practice Location Address
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Address Line | 200 HEALTHWAY
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City | POTOSI
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State | MO
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Zip | 63664-1420
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Country | US
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Telephone | 573-438-0751
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Fax | 573-438-5460
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Provider Business Mailing Address
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Address Line | 300 HEALTHWAY
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City | POTOSI
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State | MO
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Zip | 63664-1420
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Country | US
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Telephone | 573-438-0751
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Fax | 573-438-5460
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 2000164180
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 036-086677
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 01041064A
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License Number State | IN
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Taxonomy #4
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | G-43387
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License Number State | CA
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Taxonomy #5
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 01041064A
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License Number State | IN
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