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Individual

DR. SUSAN WEAVER HAWN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
85 MEMORIAL DR, JEFFERSON, GA 30549-1257
(706) 367-7621
(706) 367-2192
Mailing address
PO BOX 820, JEFFERSON, GA 30549-0820
(706) 367-7621
(706) 367-2192

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
037562
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00838318A
GA
01
080190120
MEDICARE RAILROAD PROVIDE
GA
01
702182
BCBS PROVIDER NUMBER
GA
Enumeration date
04/20/2006
Last updated
10/25/2011
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