Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | 87-362 | NM |
NPI | 1013083898 |
---|---|
Provider Name | Dr. William B Hawk |
First Address | Albuquerque, NM 87113-2472 |
Second Address | Albuquerque, NM 87113-2472 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/11/2006 |
Last Update Date | 03/01/2012 |