Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207L00000X | Anesthesiologist | 35492 | IA |
NPI | 1003860636 |
---|---|
Provider Name | Frank Edward Hawkins |
First Address | Waterloo, IA 50701-9086 |
Second Address | Waterloo, IA 50702-5739 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/05/2006 |
Last Update Date | 06/01/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
13811 | WELLMARK HEALTH PLAN (01) | IA |
421417307 J3 | JOHN DEERE HEALTH PLAN (01) | IA |
4554295 | (05) | IA |
F32116 | (02) |