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General NPI Number Information
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NPI Number | 1174735906
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Entity Type | Organization
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Legal Business Name | CLAREMONT FAMILY MEDICINE, P.A.
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Dates
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Enumeration Date | 05/04/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 3221 W MAIN ST
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City | CLAREMONT
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State | NC
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Zip | 28610-9692
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Country | US
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Telephone | 828-459-4445
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Fax | 828-459-4434
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Provider Business Mailing Address
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Address Line | PO BOX 580
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City | CLAREMONT
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State | NC
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Zip | 28610-0580
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Country | US
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Telephone | 828-459-4445
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Fax | 828-459-4434
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MARK DOUGLAS HAWKINS
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Credential | M.D.
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Telephone | 828-459-4445
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 102913
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License Number State | NC
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