MEDICARE: DR. JEFFREY E HAWKE MD

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	2083X0100X	Occupational Medicine Physician	23964	CO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1407845316
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JEFFREY E HAWKE MD

Provider Business Mailing Address
First Line	:	4900 S MONACO ST
Second Line	:	SUITE 210
City	:	DENVER
State	:	CO
Zip	:	80237-3486
Country	:	US
Telephone Number	:	303-292-0034
Fax Number	:	303-292-0097

Provider Business Practice Location Address
First Line	:	9195 GRANT ST
Second Line	:	SUITE 100
City	:	THORNTON
State	:	CO
Zip	:	80229-4386
Country	:	US
Telephone Number	:	303-292-0034
Fax Number	:	303-292-0097

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

Provider Enumeration Date	:	10/14/2005
Last Update Date	:	04/04/2012

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