Individual
JACKIE HAKEEM HAWKINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
700 W GROVE ST, EL DORADO, AR 71730-4416
(870) 864-3390
(870) 864-2152
Mailing address
2019 RICHMOND RD # 209, TEXARKANA, TX 75503-2406
(430) 274-4671
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
230133
AR
Other
Enumeration date
08/26/2024
Last updated
08/26/2024
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