Provider Demographics
NPI:1275771776
Name:HAWKINS, JEFFREY MICHAEL (PT)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:MICHAEL
Last Name:HAWKINS
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3853 BARCROFT LN
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22312-1162
Mailing Address - Country:US
Mailing Address - Phone:703-237-2000
Mailing Address - Fax:703-237-2155
Practice Address - Street 1:803 W BROAD ST
Practice Address - Street 2:SUITE 600
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22046-3130
Practice Address - Country:US
Practice Address - Phone:703-237-2000
Practice Address - Fax:703-237-2155
Is Sole Proprietor?:No
Enumeration Date:2009-01-22
Last Update Date:2012-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPT870957225100000X
VA2305205598225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist