Provider Demographics
NPI:1083604961
Name:HAWKINS, HAROLD W (MD)
Entity Type:Individual
Prefix:DR
First Name:HAROLD
Middle Name:W
Last Name:HAWKINS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3213 DAUPHIN ST
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36606-4038
Mailing Address - Country:US
Mailing Address - Phone:251-479-9538
Mailing Address - Fax:251-479-4613
Practice Address - Street 1:3213 DAUPHIN ST
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36606-4038
Practice Address - Country:US
Practice Address - Phone:251-479-9538
Practice Address - Fax:251-479-4613
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-24
Last Update Date:2012-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALAL6322174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALC71862Medicare UPIN
AL000003338Medicare ID - Type Unspecified