Provider Demographics
NPI:1184919565
Name:HAWKS, JON DAVID (RN, MPHM)
Entity type:Individual
Prefix:
First Name:JON
Middle Name:DAVID
Last Name:HAWKS
Suffix:
Gender:M
Credentials:RN, MPHM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 DENNISON AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43201-3262
Mailing Address - Country:US
Mailing Address - Phone:614-884-4400
Mailing Address - Fax:614-884-4484
Practice Address - Street 1:1100 DENNISON AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43201-3262
Practice Address - Country:US
Practice Address - Phone:614-884-4400
Practice Address - Fax:614-884-4484
Is Sole Proprietor?:No
Enumeration Date:2011-06-14
Last Update Date:2011-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.349394-163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse