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NPI Code Detail

MEDICARE: HAWKINS PHYSICIAN SERVICES, PLLC

MEDICARE: HAWKINS PHYSICIAN SERVICES, PLLC
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
1207RS0012XSleep Medicine (Internal Medicine) Physician
2207RP1001XPulmonary Disease Physician41496TN

Other Identifiers

General Provider Information

NPI Number : 1437502960
Entity Type Code : Organization
Provider Name (Legal Business Name) : HAWKINS PHYSICIAN SERVICES, PLLC
Provider Business Mailing Address
First Line : 1112 E MAIN ST
Second Line :
City : ROGERSVILLE
State : TN
Zip : 37857-2808
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1112 E MAIN ST
Second Line :
City : ROGERSVILLE
State : TN
Zip : 37857-2808
Country : US
Telephone Number : 423-293-3711
Fax Number : 423-293-3900
Authorized Official
Title or Position : PHYSICIAN
Name : LATA SHAH
Credential : MD
Telephone Number : 423-293-3711
Provider Enumeration Date : 07/20/2016
Last Update Date : 03/10/2023

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1902856990 — KIM A COLLINSON MD
Practice Location Address:
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Directions to “HAWKINS PHYSICIAN SERVICES, PLLC ” Practice Location

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