Provider Demographics
NPI:1275796757
Name:HAWKINS, URSELINE A (MD)
Entity Type:Individual
Prefix:DR
First Name:URSELINE
Middle Name:A
Last Name:HAWKINS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:CAROLINE
Other - Last Name:COLBERT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, CCC/SLP
Mailing Address - Street 1:PO BOX 2839
Mailing Address - Street 2:
Mailing Address - City:MERIDIAN
Mailing Address - State:MS
Mailing Address - Zip Code:39302-2839
Mailing Address - Country:US
Mailing Address - Phone:601-703-3480
Mailing Address - Fax:601-703-0124
Practice Address - Street 1:1516 23RD AVE
Practice Address - Street 2:
Practice Address - City:MERIDIAN
Practice Address - State:MS
Practice Address - Zip Code:39301-4026
Practice Address - Country:US
Practice Address - Phone:601-703-3820
Practice Address - Fax:601-703-0125
Is Sole Proprietor?:No
Enumeration Date:2008-07-06
Last Update Date:2014-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS21770207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS04327059Medicaid
MS316621YJ5DMedicare PIN