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Blaine Hawkes
NPI 1700135340 · on the registry since 2012
Practice
- Address
- 50 S Highway 93
Shoshone, ID 83352 - Phone
- (801) 942-3311
- Fax
- (801) 495-5303
Registry record
- Primary taxonomy
- 225100000X
225100000X
- Licence states on file
- UT
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2019-10-02
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Idaho