Individual
DR. THOMAS H HAWK JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
740 PRINCE AVE, BUILDING 8A, ATHENS, GA 30606-5908
(706) 353-1630
(706) 543-6825
Mailing address
740 PRINCE AVE, BUILDING 8A, ATHENS, GA 30606-5908
(706) 353-1630
(706) 543-6825
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
019390
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000185039A
—
GA
05
—
000185039B
—
GA
01
—
10058985
AMERIGROUP
GA
01
—
341986
WELLCARE
GA
01
—
408023018
RAIL ROAD MEDICARE PROV#
GA
01
—
52004391
BLUE CROSS AND BLUE SHIEL
GA
Enumeration date
01/18/2007
Last updated
04/02/2014
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