Provider Demographics
NPI:1972575884
Name:HAWKINS, JOHN CLIFFORD III (MD)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:CLIFFORD
Last Name:HAWKINS
Suffix:III
Gender:M
Credentials:MD
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 44008
Mailing Address - Street 2:UFJP NEUROSURGERY
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32231-4008
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:580 W 8TH ST
Practice Address - Street 2:UFJP NEUROSURGERY
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32209-6533
Practice Address - Country:US
Practice Address - Phone:904-244-3950
Practice Address - Fax:904-244-9563
Is Sole Proprietor?:No
Enumeration Date:2006-02-03
Last Update Date:2009-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME33829207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000184346CMedicaid
FL0384402-00Medicaid
FLBQ557ZMedicare PIN
FLD61785Medicare UPIN
FL0384402-00Medicaid
GA000184346CMedicaid