Provider Demographics
NPI:1720749971
Name:HAWKINS, SAWYER ALAN (PHARMD)
Entity type:Individual
Prefix:
First Name:SAWYER
Middle Name:ALAN
Last Name:HAWKINS
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5208 NW PENNINGTON LN
Mailing Address - Street 2:
Mailing Address - City:BLUE SPRINGS
Mailing Address - State:MO
Mailing Address - Zip Code:64015-2300
Mailing Address - Country:US
Mailing Address - Phone:417-576-8586
Mailing Address - Fax:
Practice Address - Street 1:625 US 40 HWY
Practice Address - Street 2:
Practice Address - City:BLUE SPRINGS
Practice Address - State:MO
Practice Address - Zip Code:64014
Practice Address - Country:US
Practice Address - Phone:816-224-4277
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-09
Last Update Date:2022-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1-103936183500000X
MO2021029270183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS1-103936OtherKANSAS BOARD OF PHARMACY
MO2021029270OtherMISSOURI BOARD OF PHARMACY