Provider Demographics
NPI:1669895660
Name:HAWLEY, HARRISON BRADFORD (MD)
Entity type:Individual
Prefix:DR
First Name:HARRISON
Middle Name:BRADFORD
Last Name:HAWLEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6761 TRAILVIEW DR
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45414-2165
Mailing Address - Country:US
Mailing Address - Phone:937-898-2153
Mailing Address - Fax:
Practice Address - Street 1:6761 TRAILVIEW DR
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45414-2165
Practice Address - Country:US
Practice Address - Phone:937-898-2153
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-27
Last Update Date:2014-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.043706207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease