Provider Demographics
NPI:1639126386
Name:HAWLEY, RONALD L (PA)
Entity Type:Individual
Prefix:MR
First Name:RONALD
Middle Name:L
Last Name:HAWLEY
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 315
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:NE
Mailing Address - Zip Code:68939-0315
Mailing Address - Country:US
Mailing Address - Phone:308-425-6221
Mailing Address - Fax:308-425-3164
Practice Address - Street 1:121 15TH AVE
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:NE
Practice Address - Zip Code:68939-1043
Practice Address - Country:US
Practice Address - Phone:308-425-6221
Practice Address - Fax:308-425-3164
Is Sole Proprietor?:No
Enumeration Date:2006-05-28
Last Update Date:2009-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE610000363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE47600743621Medicaid
NE47600743622Medicaid
NE47600743612Medicaid
NE47600743623Medicaid
R78168Medicare UPIN
NE47600743623Medicaid