Individual
DR. KENNETH D HAWN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
509 HAMACHER ST, SUITE 103, WATERLOO, IL 62298-1592
(618) 939-2273
(618) 939-0245
Mailing address
509 HAMACHER ST, SUITE 103, WATERLOO, IL 62298-1592
(618) 939-2273
(618) 939-0245
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
036135043
IL
208000000X
Pediatrics Physician
2003018920
MO
208000000X
Pediatrics Physician
E-4451
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
157028001
—
AR
Enumeration date
08/12/2005
Last updated
08/27/2014
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