Provider Demographics
NPI:1306862917
Name:TWO HAWK, SOPHIE M (MD)
Entity Type:Individual
Prefix:DR
First Name:SOPHIE
Middle Name:M
Last Name:TWO HAWK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 1946
Mailing Address - Street 2:TAOS PICURIS HEALTH CENTER
Mailing Address - City:TAOS
Mailing Address - State:NM
Mailing Address - Zip Code:87571
Mailing Address - Country:US
Mailing Address - Phone:575-758-4224
Mailing Address - Fax:575-751-5210
Practice Address - Street 1:1090 GOAT SPRINGS RD
Practice Address - Street 2:TAOS PICURIS HEALTH CENTER
Practice Address - City:TAOS
Practice Address - State:NM
Practice Address - Zip Code:87571
Practice Address - Country:US
Practice Address - Phone:575-758-4224
Practice Address - Fax:575-751-5210
Is Sole Proprietor?:No
Enumeration Date:2006-07-15
Last Update Date:2019-04-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CODR.0059656208M00000X
SD3375207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD8HZ12RMedicare ID - Type Unspecified
SDE61830Medicare UPIN