Provider Demographics
NPI:1982837035
Name:HAWKINS, NATHAN J (OD)
Entity Type:Individual
Prefix:
First Name:NATHAN
Middle Name:J
Last Name:HAWKINS
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 267
Mailing Address - Street 2:NAVAL HOSPITAL, ATTN PROFESSIONAL
Mailing Address - City:SPANISH FORK
Mailing Address - State:UT
Mailing Address - Zip Code:84660-0267
Mailing Address - Country:US
Mailing Address - Phone:801-794-3937
Mailing Address - Fax:801-794-9880
Practice Address - Street 1:BLDG 1145 STURGIS ST.
Practice Address - Street 2:NAVAL HOSPITAL, ATTN PROFESSIONAL AFFAIRS
Practice Address - City:TWENTYNINE PALMS
Practice Address - State:CA
Practice Address - Zip Code:92278-8250
Practice Address - Country:US
Practice Address - Phone:760-830-2194
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-08-24
Last Update Date:2017-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT7383575-9934152W00000X
UT7383575-8908152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist