Provider Demographics
NPI:1710759055
Name:HAWKINS, RASHAD (CCL)
Entity Type:Individual
Prefix:MR
First Name:RASHAD
Middle Name:
Last Name:HAWKINS
Suffix:
Gender:M
Credentials:CCL
Other - Prefix:
Other - First Name:RASHAD
Other - Middle Name:
Other - Last Name:HAWKINS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CARDIAC CATH LAB
Mailing Address - Street 1:PO BOX 5695
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30023-5695
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4575 WEBB BRIDGE RD
Practice Address - Street 2:
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30005-4256
Practice Address - Country:US
Practice Address - Phone:404-491-9116
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-30
Last Update Date:2023-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225A00000X, 183700000X
NY3747A0650X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician
No225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist
No3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider