Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122300000X | Dentist | 0401414029 | VA |
NPI | 1003251992 |
---|---|
Provider Name | Dr. Julie Baird Hawley |
First Address | Emporia, VA 23847-1218 |
Second Address | Emporia, VA 23847-1218 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/05/2013 |
Last Update Date | 09/07/2013 |