Individual
WESLEY HAWKINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2796 N HIGHLAND AVE, SUITE D, JACKSON, TN 38305-1846
(731) 736-0970
(731) 736-1909
Mailing address
11 WYNDCHASE DR, JACKSON, TN 38305-7529
(731) 616-1558
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
36105
TN
207Q00000X
Family Medicine Physician
MD36105
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3877763
—
TN
05
—
3877764
—
TN
01
—
4105330
BCBS
—
01
—
P00327732
RR MEDICARE
—
Enumeration date
07/10/2006
Last updated
02/11/2013
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