Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0131X | Foot Surgery | SC002734L | PA |
NPI | 1326094160 |
---|---|
Provider Name | Dr. John Edward Hawley JR. |
First Address | Yardley, PA 19067-7706 |
Second Address | Yardley, PA 19067-7706 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/05/2006 |
Last Update Date | 20/04/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
T-28591 | (02) | PA |