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NPI Code Detail

MEDICARE: DR. JEFFREY RONALD HAWK DO

MEDICARE:  DR. JEFFREY RONALD HAWK  DO
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
1207Q00000XFamily Medicine Physician4302WV

General Provider Information

NPI Number : 1881755338
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JEFFREY RONALD HAWK DO
Provider Business Mailing Address
First Line : 1448 10TH AVENUE
Second Line : SUITE 304
City : HUNTINGTON
State : WV
Zip : 25701-3579
Country : US
Telephone Number : 304-691-6381
Fax Number : 304-691-8591
Provider Business Practice Location Address
First Line : 67 HEREFORD LANE
Second Line :
City : APPLE GROVE
State : WV
Zip : 25502-9403
Country : US
Telephone Number : 304-733-8750
Fax Number : 304-908-6042
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/12/2006
Last Update Date : 07/29/2024

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Directions to “ DR. JEFFREY RONALD HAWK DO” Practice Location

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