Individual
DR. JACK HAWKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
9191 W. THUNDERBIRD RD., SUITE D-105, PEORIA, AZ 85381-4816
(623) 849-3811
(623) 849-5221
Mailing address
9191 W. THUNDERBIRD RD., SUITE D-105, PEORIA, AZ 85381-4816
(623) 849-3811
(623) 849-5221
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
4049
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
950982
—
AZ
Enumeration date
08/30/2006
Last updated
07/09/2007
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