Provider Demographics
NPI:1982609004
Name:HAWKINS, CASSANDRA (MD)
Entity Type:Individual
Prefix:DR
First Name:CASSANDRA
Middle Name:
Last Name:HAWKINS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:CASSANDRA
Other - Middle Name:
Other - Last Name:HAWKINS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:491A CRAFT ST
Mailing Address - Street 2:
Mailing Address - City:HOLLY SPRINGS
Mailing Address - State:MS
Mailing Address - Zip Code:38635-3251
Mailing Address - Country:US
Mailing Address - Phone:662-252-6416
Mailing Address - Fax:662-252-3355
Practice Address - Street 1:491A CRAFT ST
Practice Address - Street 2:
Practice Address - City:HOLLY SPRINGS
Practice Address - State:MS
Practice Address - Zip Code:38635-3251
Practice Address - Country:US
Practice Address - Phone:662-252-6416
Practice Address - Fax:662-252-3355
Is Sole Proprietor?:No
Enumeration Date:2005-06-15
Last Update Date:2020-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS18390207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS00800785Medicaid
MS080003849Medicare ID - Type UnspecifiedMEDICARE