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Individual

DR. COLETTE HAWTHORNE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
1833 BOULEVARD, JACKSONVILLE, FL 32206-4382
(904) 232-2751
Mailing address
1833 BOULEVARD STREET, NORTH FLORIDA/SOUTH GEORGIA VETERANS HEALTH SYSTEM, JACKSONVILLE, FL 32206
(904) 232-2751

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
25937
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
64259377
KY
Enumeration date
10/04/2006
Last updated
09/25/2012
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