Provider Demographics
NPI:1225047145
Name:HAWXBY, ALAN MARSHALL (MD)
Entity Type:Individual
Prefix:DR
First Name:ALAN
Middle Name:MARSHALL
Last Name:HAWXBY
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 1:4900 S. MONACO ST
Mailing Address - Street 2:#210
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80237-3486
Mailing Address - Country:US
Mailing Address - Phone:405-271-7498
Mailing Address - Fax:405-271-4328
Practice Address - Street 1:940 N. E. 13TH STREET
Practice Address - Street 2:SUITE 3000
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73104-5099
Practice Address - Country:US
Practice Address - Phone:405-271-7498
Practice Address - Fax:405-271-4328
Is Sole Proprietor?:No
Enumeration Date:2006-08-07
Last Update Date:2022-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS19667204F00000X
CODR.0068875204F00000X
AL26012208600000X
OK28113204F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204F00000XAllopathic & Osteopathic PhysiciansTransplant Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL009955315Medicaid
OK200314170AMedicaid
AL009955185Medicaid
AL009955185Medicaid
MS512I020029Medicare PIN
AL051522436Medicare ID - Type Unspecified
MS512I020042Medicare PIN
OKOKA103109Medicare PIN