Provider Demographics
NPI:1487525820
Name:HAWTHORNE OB/GYN LLC
Entity type:Organization
Organization Name:HAWTHORNE OB/GYN LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:TAYLOR
Authorized Official - Last Name:SHOLES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:706-286-8692
Mailing Address - Street 1:1000 HAWTHORNE AVE STE M
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:GA
Mailing Address - Zip Code:30606-2168
Mailing Address - Country:US
Mailing Address - Phone:706-286-8692
Mailing Address - Fax:706-286-8693
Practice Address - Street 1:1000 HAWTHORNE AVE
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:GA
Practice Address - Zip Code:30606-2168
Practice Address - Country:US
Practice Address - Phone:706-286-8692
Practice Address - Fax:706-286-8393
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-17
Last Update Date:2025-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty