Provider Demographics
NPI:1952382731
Name:HAWKINS, JAMES R (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:R
Last Name:HAWKINS
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 1:2727 MADISON RD
Mailing Address - Street 2:SUITE 303B
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45209-2276
Mailing Address - Country:US
Mailing Address - Phone:513-721-0990
Mailing Address - Fax:513-721-5313
Practice Address - Street 1:2727 MADISON RD
Practice Address - Street 2:SUITE 303B
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45209-2276
Practice Address - Country:US
Practice Address - Phone:513-721-0990
Practice Address - Fax:513-721-5313
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-09
Last Update Date:2011-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34138174400000X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0195506Medicaid
KY64783343Medicaid
OH0203569Medicaid
OH260006409OtherRR MEDICARE INDIVIDUAL
OHDH1300OtherRR MEDICARE GROUP
OHDH1300OtherRR MEDICARE GROUP
OHJA9280881Medicare ID - Type UnspecifiedOHIO MEDICARE GROUP
OH260006409OtherRR MEDICARE INDIVIDUAL
OHA77333Medicare UPIN