Provider Demographics
NPI:1285704411
Name:HAWKINS, JOHN PAUL (OD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:PAUL
Last Name:HAWKINS
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1128
Mailing Address - Street 2:
Mailing Address - City:WOODWARD
Mailing Address - State:OK
Mailing Address - Zip Code:73802-1128
Mailing Address - Country:US
Mailing Address - Phone:580-256-7755
Mailing Address - Fax:580-256-4819
Practice Address - Street 1:1709 MAIN ST
Practice Address - Street 2:
Practice Address - City:WOODWARD
Practice Address - State:OK
Practice Address - Zip Code:73801-2938
Practice Address - Country:US
Practice Address - Phone:580-256-7755
Practice Address - Fax:580-256-4819
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2008-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK766152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK731056684001OtherBLUE CROSS BLUE SHIELD OK
OKCT0824OtherRR MEDICARE
OKCT0824OtherRR MEDICARE
OK731056684001OtherBLUE CROSS BLUE SHIELD OK