Provider Demographics
NPI:1649561242
Name:HAWKINS, KELLIE L (MD)
Entity type:Individual
Prefix:DR
First Name:KELLIE
Middle Name:L
Last Name:HAWKINS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:KELLIE
Other - Middle Name:LEIGH
Other - Last Name:FAIRCLOTH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:777 BANNOCK ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80204-4597
Mailing Address - Country:US
Mailing Address - Phone:303-602-3700
Mailing Address - Fax:303-602-3676
Practice Address - Street 1:777 BANNOCK ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80204-4597
Practice Address - Country:US
Practice Address - Phone:303-602-3700
Practice Address - Fax:303-602-3676
Is Sole Proprietor?:No
Enumeration Date:2011-04-29
Last Update Date:2024-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODR.0053834207RI0200X, 207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease