Provider Demographics
NPI:1033343470
Name:HAWKINS, JASON LEE (DC)
Entity Type:Individual
Prefix:
First Name:JASON
Middle Name:LEE
Last Name:HAWKINS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17014 W BELL RD STE 103
Mailing Address - Street 2:
Mailing Address - City:SURPRISE
Mailing Address - State:AZ
Mailing Address - Zip Code:85374-2479
Mailing Address - Country:US
Mailing Address - Phone:602-680-5161
Mailing Address - Fax:602-680-5161
Practice Address - Street 1:17014 W BELL RD STE 103
Practice Address - Street 2:
Practice Address - City:SURPRISE
Practice Address - State:AZ
Practice Address - Zip Code:85374-2479
Practice Address - Country:US
Practice Address - Phone:602-680-5161
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-13
Last Update Date:2024-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ8041111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor