Provider Demographics
NPI:1477544666
Name:HAWKS, STEPHEN W (DO)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:W
Last Name:HAWKS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:507 E 16TH ST STE 1
Mailing Address - Street 2:
Mailing Address - City:WELLINGTON
Mailing Address - State:KS
Mailing Address - Zip Code:67152-2828
Mailing Address - Country:US
Mailing Address - Phone:620-326-3301
Mailing Address - Fax:620-326-7086
Practice Address - Street 1:507 E 16TH ST
Practice Address - Street 2:STE 1
Practice Address - City:WELLINGTON
Practice Address - State:KS
Practice Address - Zip Code:67152-2828
Practice Address - Country:US
Practice Address - Phone:620-326-3301
Practice Address - Fax:620-326-7086
Is Sole Proprietor?:No
Enumeration Date:2005-11-04
Last Update Date:2020-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS529355207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
171115OtherCOVENTRY
7849337OtherAETNA
KS13764OtherPREFERRED PLUS OF KANSAS
KS102995OtherBCBS
A0529355OtherUNICARE
KS1004580530AMedicaid
250683403OtherUNITED HEALTH CARE
461016OtherCMFHP
CS5682OtherRAILROAD MEDICARE CLINIC ID
P00058389OtherRAILROAD MEDICARE
CS5682OtherRAILROAD MEDICARE CLINIC ID
P00058389OtherRAILROAD MEDICARE