Organization
WISE WOMAN OB/GYN, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NANCI L. HAWKINS MD (PRESIDENT)
(315) 782-6262
Entity
Organization
Contact information
Practice address
172 CLINTON ST, WATERTOWN, NY 13601-3602
(315) 782-6262
(315) 782-5181
Mailing address
1001 W FAYETTE ST, STE 400, SYRACUSE, NY 13204-2859
(315) 472-1488
(315) 476-1792
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
—
—
363LW0102X
Women's Health Nurse Practitioner
—
—
367A00000X
Advanced Practice Midwife
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02751077
—
NY
Enumeration date
05/15/2006
Last updated
05/06/2008
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