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General NPI Number Information
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NPI Number | 1861870834
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Entity Type | Individual
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Provider Name | ABDUL HAWKINS MBA
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Gender | Male
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Dates
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Enumeration Date | 05/11/2015
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Last Update Date | 05/10/2019
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Provider Practice Location Address
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Address Line | 555 WHITEHALL ST SW STE O
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City | ATLANTA
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State | GA
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Zip | 30303-3715
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Country | US
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Telephone | 678-788-3646
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1094
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City | CONLEY
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State | GA
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Zip | 30288-7000
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Country | US
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Telephone | 678-788-3646
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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 | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number |
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License Number State |
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