MEDICARE: DR. ELIZABETH KILGOUR HAWKES M.D.

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	208000000X	Pediatrics Physician	G85127	CA

General Provider Information

NPI Number	:	1538160353
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ELIZABETH KILGOUR HAWKES M.D.

Provider Business Mailing Address
First Line	:	7015 BORG RD NE
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87111-5883
Country	:	US
Telephone Number	:	505-298-1456
Fax Number	:

Provider Business Practice Location Address
First Line	:	2001 EL CENTRO FAMILIAR BLVD SW
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87105-4592
Country	:	US
Telephone Number	:	505-873-7400
Fax Number	:

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

Provider Enumeration Date	:	08/02/2005
Last Update Date	:	03/15/2021

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