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MARTHA NAN HAWKES PHP

Clinical Neuropsychologist

Germantown, Tennessee

Provider NPI: 1477544997

Organization Information:
Organization Name:  MARTHA NAN HAWKES PHP
Authorized Official:  MARTHA NAN HAWKES  NEUROPSYCHOLOGIST  901-7513571

Practice Location:
7655 POPLAR AVE SUITE 365 GERMANTOWN, TN 38138 US
Tel: 901-751-3571  Fax: 901-751-3572

Business Mailing Address:
7655 POPLAR AVE SUITE 365 GERMANTOWN, TN 38138 US
Tel: 901-751-3571  Fax: 901-751-3572

Entity Type: Organization

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y103G00000XBehavioral Health & Social Service Providers
Clinical Neuropsychologist
TNP0000001132

Other Provider Identifiers:

IssuerNumberStateType
368533004
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin







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