Individual
KEITH HAWKINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CFSA, CSA
Contact information
Practice address
8498 GLENVIEW ST, DOUGLASVILLE, GA 30134-5639
(225) 810-7571
Mailing address
PO BOX 871063, STONE MOUNTAIN, GA 30087-0027
(225) 810-7571
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
18-356
GA
363AS0400X
Surgical Physician Assistant
Primary
—
—
Other
Enumeration date
04/15/2020
Last updated
10/14/2020
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