Provider Demographics
NPI:1184870693
Name:HAWKER, NICHOLAS PAUL (OD)
Entity type:Individual
Prefix:DR
First Name:NICHOLAS
Middle Name:PAUL
Last Name:HAWKER
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 1:440 PATROL RD
Mailing Address - Street 2:
Mailing Address - City:JEFFERSONVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47130-7754
Mailing Address - Country:US
Mailing Address - Phone:812-288-9898
Mailing Address - Fax:812-288-5752
Practice Address - Street 1:440 PATROL RD
Practice Address - Street 2:
Practice Address - City:JEFFERSONVILLE
Practice Address - State:IN
Practice Address - Zip Code:47130-7754
Practice Address - Country:US
Practice Address - Phone:812-288-9898
Practice Address - Fax:812-288-5752
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-15
Last Update Date:2016-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1745DT152W00000X
IN18003503A152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
INM400033970Medicare PIN