Provider Demographics
NPI:1083954176
Name:HAWKES, TIMOTHY AARON (DO)
Entity type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:AARON
Last Name:HAWKES
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 W 100 N STE S201
Mailing Address - Street 2:
Mailing Address - City:VERNAL
Mailing Address - State:UT
Mailing Address - Zip Code:84078-2036
Mailing Address - Country:US
Mailing Address - Phone:435-789-0305
Mailing Address - Fax:435-789-0307
Practice Address - Street 1:150 W 100 N STE S201
Practice Address - Street 2:
Practice Address - City:VERNAL
Practice Address - State:UT
Practice Address - Zip Code:84078-2036
Practice Address - Country:US
Practice Address - Phone:435-789-0305
Practice Address - Fax:435-789-0307
Is Sole Proprietor?:No
Enumeration Date:2013-02-26
Last Update Date:2025-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS621762570207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS201156280AMedicaid