Provider Demographics
NPI:1568449841
Name:HAWKINS, JOHN WOODRUFF (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:WOODRUFF
Last Name:HAWKINS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8243 MEADOWBRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:MECHANICSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:23116-2329
Mailing Address - Country:US
Mailing Address - Phone:804-730-1481
Mailing Address - Fax:804-730-8464
Practice Address - Street 1:8243 MEADOWBRIDGE RD
Practice Address - Street 2:
Practice Address - City:MECHANICSVILLE
Practice Address - State:VA
Practice Address - Zip Code:23116-2329
Practice Address - Country:US
Practice Address - Phone:804-730-1481
Practice Address - Fax:804-730-8464
Is Sole Proprietor?:No
Enumeration Date:2005-12-28
Last Update Date:2011-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101036931207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAC06115OtherGROUP PTAN
VA010065828Medicaid
003606R05Medicare ID - Type Unspecified
VA010065828Medicaid