Organization
KENNETH B HAWTHORNE JR MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KENNETH B HAWTHORNE JR. MD (PRESIDENT/OWNER)
(386) 671-0115
Entity
Organization
Contact information
Practice address
106 N OLD KINGS RD, STE E, ORMOND BEACH, FL 32174-9505
(386) 671-0115
(386) 671-0844
Mailing address
106 N OLD KINGS RD, STE E, ORMOND BEACH, FL 32174-9505
(386) 671-0115
(386) 671-0844
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
Other
Enumeration date
12/15/2009
Last updated
10/03/2011
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