Provider Demographics
NPI:1194810234
Name:JAMES R HAWKINS MD & ASSOCIATES
Entity type:Organization
Organization Name:JAMES R HAWKINS MD & ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:MS
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:A
Authorized Official - Last Name:YOUNG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:513-721-0990
Mailing Address - Street 1:2727 MADISON ROAD,
Mailing Address - Street 2:SUITE 303B
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45209
Mailing Address - Country:US
Mailing Address - Phone:513-721-0990
Mailing Address - Fax:513-721-5313
Practice Address - Street 1:2727 MADISON ROAD,
Practice Address - Street 2:SUITE 303B
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45209
Practice Address - Country:US
Practice Address - Phone:513-721-0990
Practice Address - Fax:513-721-5313
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-04
Last Update Date:2011-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH034138101YM0800X, 174400000X
OHE0000762101YM0800X
OH341382084P0800X
OHNS-03684364SP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
No174400000XOther Service ProvidersSpecialistGroup - Single Specialty
No364SP0808XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH260006409OtherRR MEDICARE INDIVIDUAL
KY64783343Medicaid
OH29340810500OtherWORKERS COMPENSATION
OHDH1300OtherRR MEDICARE GROUP
OHP00473812OtherRR MEDICARE INDIVIDUAL
OH0203569OtherOHIO GROUP MEDICAID
OH38854194101OtherWORKERS COMPENSATION INDIVIDUAL
OH0195506Medicaid
OHNS00612OtherOHIO MEDICARE INDIVIDUAL
KY64783343Medicaid
OHNS00612OtherOHIO MEDICARE INDIVIDUAL
OH29340810500OtherWORKERS COMPENSATION
OH260006409OtherRR MEDICARE INDIVIDUAL