Provider Demographics
NPI:1942321484
Name:HAWKINS, STEPHEN ALLEN (DC)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:ALLEN
Last Name:HAWKINS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:117 S BROADWAY ST
Mailing Address - Street 2:
Mailing Address - City:NEW ULM
Mailing Address - State:MN
Mailing Address - Zip Code:56073-3114
Mailing Address - Country:US
Mailing Address - Phone:507-354-4529
Mailing Address - Fax:507-354-7528
Practice Address - Street 1:117 S BROADWAY ST
Practice Address - Street 2:
Practice Address - City:NEW ULM
Practice Address - State:MN
Practice Address - Zip Code:56073-3114
Practice Address - Country:US
Practice Address - Phone:507-354-4529
Practice Address - Fax:507-354-7528
Is Sole Proprietor?:No
Enumeration Date:2007-04-03
Last Update Date:2008-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1906111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN43126HAOtherBCBS
MN154827100Medicaid
MN359000370Medicare ID - Type Unspecified
MN43126HAOtherBCBS