MEDICARE: JOHN CLIFFORD HAWKINS III 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	207T00000X	Neurological Surgery Physician	ME33829	FL

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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1972575884
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN CLIFFORD HAWKINS III MD

Provider Business Mailing Address
First Line	:	PO BOX 44008
Second Line	:	UFJP NEUROSURGERY
City	:	JACKSONVILLE
State	:	FL
Zip	:	32231-4008
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	580 W 8TH ST
Second Line	:	UFJP NEUROSURGERY
City	:	JACKSONVILLE
State	:	FL
Zip	:	32209-6533
Country	:	US
Telephone Number	:	904-244-3950
Fax Number	:	904-244-9563

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

Provider Enumeration Date	:	02/03/2006
Last Update Date	:	06/04/2009

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