Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RI0200X | Infectious Disease | 0101042923 | VA |
NPI | 1073566907 |
---|---|
Provider Name | Dr. Clifton Allen Hawkes |
First Address | Richmond, VA 23227-1149 |
Second Address | Petersburg, VA 23805-9275 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/05/2006 |
Last Update Date | 05/02/2020 |