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General NPI Number Information
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NPI Number | 1861838724
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Entity Type | Individual
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Provider Name | CLIFTON BERNARD HAWKINS MT(ASCP)
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Gender | Male
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Dates
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Enumeration Date | 05/20/2013
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Last Update Date | 05/20/2013
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Provider Practice Location Address
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Address Line | 11875 S SUNSET DR STE 300
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City | OLATHE
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State | KS
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Zip | 66061-2794
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Country | US
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Telephone | 913-477-8365
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Fax | 913-715-2476
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Provider Business Mailing Address
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Address Line | 11875 S SUNSET DR STE 300
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City | OLATHE
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State | KS
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Zip | 66061-2794
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Country | US
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Telephone | 913-477-8365
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Fax | 913-715-2476
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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 | 246RM2200X
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Taxonomy Name | Medical Laboratory Technician
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License Number |
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License Number State |
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