Provider Demographics
NPI:1972674422
Name:HAWES, BENJAMIN B (LAC)
Entity Type:Individual
Prefix:MR
First Name:BENJAMIN
Middle Name:B
Last Name:HAWES
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 202876
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80220-8876
Mailing Address - Country:US
Mailing Address - Phone:720-370-2711
Mailing Address - Fax:720-370-2925
Practice Address - Street 1:1 W 1ST ST
Practice Address - Street 2:
Practice Address - City:CORTEZ
Practice Address - State:CO
Practice Address - Zip Code:81321-3507
Practice Address - Country:US
Practice Address - Phone:970-565-0230
Practice Address - Fax:970-565-3463
Is Sole Proprietor?:No
Enumeration Date:2006-11-13
Last Update Date:2020-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO897171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist