Provider Demographics
NPI:1881838894
Name:HAWKINS, JANET S (DO)
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:S
Last Name:HAWKINS
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:JANET
Other - Middle Name:S
Other - Last Name:HAWKINS-KEGLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:265 MAIN ST STE 201
Mailing Address - Street 2:
Mailing Address - City:BIDDEFORD
Mailing Address - State:ME
Mailing Address - Zip Code:04005-3091
Mailing Address - Country:US
Mailing Address - Phone:800-683-8313
Mailing Address - Fax:
Practice Address - Street 1:59 EAST AVE
Practice Address - Street 2:
Practice Address - City:LEWISTON
Practice Address - State:ME
Practice Address - Zip Code:04240
Practice Address - Country:US
Practice Address - Phone:207-784-1680
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-04-22
Last Update Date:2018-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEDO2096207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME2096OtherMAINE MEDICAL LICENSE NUMBER
ME434041299Medicaid
ME2096OtherMAINE MEDICAL LICENSE NUMBER