MEDICARE: DAMON HAWKINS DPH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	10588	OK

General Provider Information

NPI Number	:	1134737695
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAMON HAWKINS DPH

Provider Business Mailing Address
First Line	:	121 S GRAND AVE
Second Line	:
City	:	CHEROKEE
State	:	OK
Zip	:	73728-2028
Country	:	US
Telephone Number	:	580-596-2411
Fax Number	:	580-596-2471

Provider Business Practice Location Address
First Line	:	121 S GRAND AVE
Second Line	:
City	:	CHEROKEE
State	:	OK
Zip	:	73728-2028
Country	:	US
Telephone Number	:	580-596-2411
Fax Number	:	580-596-2471

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/21/2020
Last Update Date	:	07/21/2020

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Directions to “ DAMON HAWKINS DPH” Practice Location

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