Individual
STEPHANIE KEAL HAWKINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A
Contact information
Practice address
1365 CLIFTON RD NE, SUITE B6168, ATLANTA, GA 30322-1013
(404) 778-3094
(404) 778-4472
Mailing address
1075 BOULDERCREST DR SE, ATLANTA, GA 30316-2268
(404) 291-3711
(404) 778-4472
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
004719
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
363816690A
—
GA
05
—
363816690B
—
GA
Enumeration date
05/12/2006
Last updated
06/18/2012
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