Provider Demographics
NPI:1326028440
Name:HAWK, JAMES M (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:M
Last Name:HAWK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 392
Mailing Address - Street 2:
Mailing Address - City:HARRISON
Mailing Address - State:AR
Mailing Address - Zip Code:72602-0392
Mailing Address - Country:US
Mailing Address - Phone:870-741-4295
Mailing Address - Fax:870-741-6569
Practice Address - Street 1:303 W NEWMAN AVE
Practice Address - Street 2:
Practice Address - City:HARRISON
Practice Address - State:AR
Practice Address - Zip Code:72601-5839
Practice Address - Country:US
Practice Address - Phone:870-741-4295
Practice Address - Fax:870-741-6569
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-17
Last Update Date:2013-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE2493207Q00000X, 207QA0401X, 208VP0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207QA0401XAllopathic & Osteopathic PhysiciansFamily MedicineAddiction Medicine
No208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR136552001Medicaid
AR149957002Medicaid
AR136552001Medicaid
AR149957002Medicaid