Provider Demographics
NPI:1073566907
Name:HAWKES, CLIFTON ALLEN (MD)
Entity Type:Individual
Prefix:DR
First Name:CLIFTON
Middle Name:ALLEN
Last Name:HAWKES
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:8580 MAGELLAN PKWY
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23227-1149
Mailing Address - Country:US
Mailing Address - Phone:804-765-6766
Mailing Address - Fax:804-765-6771
Practice Address - Street 1:50 MEDICAL PARK BLVD STE A
Practice Address - Street 2:
Practice Address - City:PETERSBURG
Practice Address - State:VA
Practice Address - Zip Code:23805-9275
Practice Address - Country:US
Practice Address - Phone:804-765-6766
Practice Address - Fax:804-765-6771
Is Sole Proprietor?:No
Enumeration Date:2006-05-19
Last Update Date:2020-02-05
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Provider Licenses
StateLicense IDTaxonomies
VA0101042923207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1073566907Medicare NSC