Provider Demographics
NPI:1124026166
Name:HAWKINS, KRISTI M (MD)
Entity Type:Individual
Prefix:
First Name:KRISTI
Middle Name:M
Last Name:HAWKINS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 S UNIVERSITY AVE
Mailing Address - Street 2:STE 200
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205-5302
Mailing Address - Country:US
Mailing Address - Phone:501-664-4117
Mailing Address - Fax:501-664-1137
Practice Address - Street 1:500 S UNIVERSITY AVE
Practice Address - Street 2:STE 200
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-5302
Practice Address - Country:US
Practice Address - Phone:501-664-4117
Practice Address - Fax:501-664-1137
Is Sole Proprietor?:No
Enumeration Date:2005-07-13
Last Update Date:2011-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE-3654207R00000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR03100012500OtherQUALCHOICE
AR7900460OtherAETNA
ARP00067812OtherRAILROAD MEDICARE
AR150520001Medicaid
AR2346630OtherUNITED HEALTHCARE
AR6165666OtherCIGNA
ARH91948Medicare UPIN
AR5M682Medicare ID - Type Unspecified