Provider Demographics
NPI:1720357650
Name:FRANCIS A. HAWTHORN,DPM,PC
Entity Type:Organization
Organization Name:FRANCIS A. HAWTHORN,DPM,PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FRANCIS
Authorized Official - Middle Name:A
Authorized Official - Last Name:HAWTHORN,DPM,PC
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-889-2323
Mailing Address - Street 1:3901 CENTRAL PIKE
Mailing Address - Street 2:SUITE 353
Mailing Address - City:HERMITAGE
Mailing Address - State:TN
Mailing Address - Zip Code:37076-3422
Mailing Address - Country:US
Mailing Address - Phone:615-889-2323
Mailing Address - Fax:615-889-2370
Practice Address - Street 1:3901 CENTRAL PIKE
Practice Address - Street 2:SUITE 353
Practice Address - City:HERMITAGE
Practice Address - State:TN
Practice Address - Zip Code:37076-3422
Practice Address - Country:US
Practice Address - Phone:615-889-2323
Practice Address - Fax:615-889-2370
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-21
Last Update Date:2012-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000000193261QP1100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP1100XAmbulatory Health Care FacilitiesClinic/CenterPodiatric
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN0433760001Medicare NSC