Provider Demographics
NPI:1003860636
Name:HAWKINS, FRANK EDWARD (MD)
Entity Type:Individual
Prefix:
First Name:FRANK
Middle Name:EDWARD
Last Name:HAWKINS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4150 KIMBALL AVE
Mailing Address - Street 2:PO BOX 2758
Mailing Address - City:WATERLOO
Mailing Address - State:IA
Mailing Address - Zip Code:50701-9086
Mailing Address - Country:US
Mailing Address - Phone:319-235-5390
Mailing Address - Fax:319-233-1630
Practice Address - Street 1:3254 KIMBALL AVE
Practice Address - Street 2:
Practice Address - City:WATERLOO
Practice Address - State:IA
Practice Address - Zip Code:50702-5739
Practice Address - Country:US
Practice Address - Phone:319-235-7246
Practice Address - Fax:319-235-3017
Is Sole Proprietor?:No
Enumeration Date:2006-05-19
Last Update Date:2012-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA35492207L00000X, 208VP0014X, 208VP0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA13811OtherWELLMARK HEALTH PLAN
IA421417307 J3OtherJOHN DEERE HEALTH PLAN
IA4554295Medicaid
IAI11358Medicare ID - Type Unspecified
IA13811OtherWELLMARK HEALTH PLAN