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General NPI Number Information
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NPI Number | 1881755338
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Entity Type | Individual
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Provider Name | JEFFREY RONALD HAWK DO
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Gender | Male
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Dates
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Enumeration Date | 12/12/2006
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Last Update Date | 07/29/2024
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Provider Practice Location Address
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Address Line | 67 HEREFORD LANE
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City | APPLE GROVE
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State | WV
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Zip | 25502-9403
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Country | US
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Telephone | 304-733-8750
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Fax | 304-908-6042
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Provider Business Mailing Address
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Address Line | 1448 10TH AVENUE SUITE 304
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City | HUNTINGTON
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State | WV
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Zip | 25701-3579
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Country | US
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Telephone | 304-691-6381
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Fax | 304-691-8591
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 4302
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License Number State | WV
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