Hawn, Kenneth D

Hawn, Kenneth D is an individual health care provider with primary practice located at 509 Hamacher St Suite 103, Waterloo IL 62298-1592. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Hawn, Kenneth D can be contacted via phone (618) 939-2273.

Contact Information

Primary practice address
509 Hamacher St Suite 103 Waterloo IL 62298-1592
Phone: (618) 939-2273
Fax: (618) 939-0245
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X E-4451 Arkansas
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 2003018920 Missouri
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 036135043 Illinois

Profile Details

NPI number 1932101532
LBN Legal business name Hawn, Kenneth D
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 12th, 2005
Last updated Aug 27th, 2014 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1932101532 NPPES
Arkansas MEDICAID 157028001

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