Individual
MONTY A HAWKINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1003 WILLOW CREEK RD, PRESCOTT, AZ 86301-1641
(480) 985-1093
(480) 296-7665
Mailing address
PO BOX 20490, MESA, AZ 85277-0490
(480) 985-1093
(480) 296-7665
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
R73586
AZ
207ZP0105X
Clinical Pathology/Laboratory Medicine Physician
Primary
57042
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
R73586
TRAINING PERMIT
AZ
Enumeration date
07/05/2012
Last updated
09/26/2023
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