Provider Demographics
NPI:1316958671
Name:HAWKINS, JOHN RANDOLPH (DMD,PA)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:RANDOLPH
Last Name:HAWKINS
Suffix:
Gender:M
Credentials:DMD,PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:513 S. 3RD STREET
Mailing Address - Street 2:
Mailing Address - City:GADSDEN
Mailing Address - State:AL
Mailing Address - Zip Code:35901
Mailing Address - Country:US
Mailing Address - Phone:256-543-7444
Mailing Address - Fax:256-543-1111
Practice Address - Street 1:513 S. 3RD STREET
Practice Address - Street 2:
Practice Address - City:GADSDEN
Practice Address - State:AL
Practice Address - Zip Code:35901
Practice Address - Country:US
Practice Address - Phone:256-543-7444
Practice Address - Fax:256-543-1111
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-11
Last Update Date:2016-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL31701223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice