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General NPI Number Information
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NPI Number | 1821663675
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Entity Type | Individual
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Provider Name | DAXTON AARON HAWKS OD, MBA
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Gender | Male
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Dates
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Enumeration Date | 05/24/2021
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Last Update Date | 12/01/2023
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Provider Practice Location Address
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Address Line | 13126 S EAGLES FLIGHT RD
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City | RIVERTON
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State | UT
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Zip | 84096-1410
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Country | US
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Telephone | 386-832-1112
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Fax | 801-477-8359
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Provider Business Mailing Address
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Address Line | 1704 W 10 S
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City | PLEASANT GROVE
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State | UT
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Zip | 84062-6253
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Country | US
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Telephone | 801-717-5655
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Fax |
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 12308049-9934
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License Number State | UT
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