Provider Demographics
NPI:1265484059
Name:HAWK, DAVID PAUL (DPM)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:PAUL
Last Name:HAWK
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:125 TOWN CREEK RD E
Mailing Address - Street 2:SUITE 3
Mailing Address - City:LENOIR CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37772-5612
Mailing Address - Country:US
Mailing Address - Phone:865-986-2700
Mailing Address - Fax:865-986-8096
Practice Address - Street 1:125 TOWN CREEK RD E
Practice Address - Street 2:SUITE 3
Practice Address - City:LENOIR CITY
Practice Address - State:TN
Practice Address - Zip Code:37772-5612
Practice Address - Country:US
Practice Address - Phone:865-986-2700
Practice Address - Fax:865-986-8096
Is Sole Proprietor?:No
Enumeration Date:2006-05-17
Last Update Date:2020-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDPM562213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNU79557Medicare UPIN
TN3353215Medicare PIN