Provider Demographics
NPI:1578213401
Name:HAWKINS, ANITWON MARKQUES
Entity Type:Individual
Prefix:
First Name:ANITWON
Middle Name:MARKQUES
Last Name:HAWKINS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1701 LAMY LN
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71201-3737
Mailing Address - Country:US
Mailing Address - Phone:318-329-0240
Mailing Address - Fax:318-329-0239
Practice Address - Street 1:1701 LAMY LN
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:LA
Practice Address - Zip Code:71201-3737
Practice Address - Country:US
Practice Address - Phone:318-329-0240
Practice Address - Fax:318-329-0239
Is Sole Proprietor?:No
Enumeration Date:2022-03-24
Last Update Date:2022-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator