Provider Demographics
NPI:1881634780
Name:HAWLEY, JOHN FARLAN (OD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:FARLAN
Last Name:HAWLEY
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3911 COFFEE RD STE B
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93308-5024
Mailing Address - Country:US
Mailing Address - Phone:661-588-8222
Mailing Address - Fax:661-588-0222
Practice Address - Street 1:3911 COFFEE RD STE B
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93308-5024
Practice Address - Country:US
Practice Address - Phone:661-588-8222
Practice Address - Fax:661-588-0222
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-08
Last Update Date:2010-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACA8487T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CASD0084870Medicaid
CACS593ZMedicare PIN
CAP00802087Medicare PIN
T10698Medicare UPIN
CA4644390001Medicare NSC