Provider Demographics
NPI:1083673339
Name:HAWSE, ELIZABETH C (MD)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:C
Last Name:HAWSE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:C
Other - Last Name:HAMM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1780 NICHOLASVILLE RD
Mailing Address - Street 2:STE 301
Mailing Address - City:LEXINGTON
Mailing Address - State:KS
Mailing Address - Zip Code:40503
Mailing Address - Country:US
Mailing Address - Phone:859-277-6636
Mailing Address - Fax:859-277-1455
Practice Address - Street 1:1780 NICHOLASVILLE RD
Practice Address - Street 2:STE 301
Practice Address - City:LEXINGTON
Practice Address - State:KS
Practice Address - Zip Code:40503
Practice Address - Country:US
Practice Address - Phone:859-277-6636
Practice Address - Fax:859-277-1455
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY35687208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64014277Medicaid