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General NPI Number Information
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NPI Number | 1457535114
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Entity Type | Individual
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Provider Name | CODY J HAWKES DO
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Gender | Male
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Dates
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Enumeration Date | 12/18/2007
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Last Update Date | 07/02/2024
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Provider Practice Location Address
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Address Line | 1240 E 100 S STE 14
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City | SAINT GEORGE
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State | UT
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Zip | 84790-3005
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Country | US
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Telephone | 356-288-2324
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Fax | 435-674-7994
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Provider Business Mailing Address
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Address Line | 1240 E 100 S STE 14
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City | ST GEORGE
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State | UT
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Zip | 84790-3005
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Country | US
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Telephone | 435-628-8232
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Fax | 435-674-7994
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | R1069
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 7696028-1204
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License Number State | UT
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Legacy Identifiers
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Identifier #1
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Identifier Code | R1069
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Identifier Type | OTHER
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Identifier State | AZ
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Identifier Issuer | TRAINING PERMIT
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Proprietary Identifiers Ever Reported
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Identifier #1
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Identifier Code | R1069
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Identifier Type | OTHER
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Identifier State | AZ
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Identifier Issuer | TRAINING PERMIT
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