Provider Demographics
NPI:1477593374
Name:HAWKINS, RODNEY LOCKWOOD (MPT)
Entity Type:Individual
Prefix:
First Name:RODNEY
Middle Name:LOCKWOOD
Last Name:HAWKINS
Suffix:
Gender:M
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 SILKWOOD LN
Mailing Address - Street 2:
Mailing Address - City:RSM
Mailing Address - State:CA
Mailing Address - Zip Code:92688-5513
Mailing Address - Country:US
Mailing Address - Phone:949-584-3645
Mailing Address - Fax:
Practice Address - Street 1:4 SILKWOOD LN
Practice Address - Street 2:
Practice Address - City:RSM
Practice Address - State:CA
Practice Address - Zip Code:92688-5513
Practice Address - Country:US
Practice Address - Phone:949-584-3645
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-08
Last Update Date:2011-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT26522225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAP88179Medicare UPIN
CAWPT26522BMedicare PIN