Susan Weaver Hawn, MD, LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

037562 Issued in GA

Legal business name

SUSAN WEAVER HAWN, MD, LLC

Practice address

85 Memorial Dr
Jefferson, GA 30549-1257

Phone

(706) 367-7621

Fax

(706) 367-2192

NPI assigned

Jan 30, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Susan W Hawn, MD

Title

Owner

Phone

(706) 367-7621

Specialties & licenses 1

Addresses

Other identifiers 4

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1319500800000",
    "number": "1790821460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 820",
            "city": "JEFFERSON",
            "state": "GA",
            "postal_code": "305490820",
            "telephone_number": "706-367-7621",
            "fax_number": "706-367-2192"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "85 MEMORIAL DR",
            "city": "JEFFERSON",
            "state": "GA",
            "postal_code": "305491257",
            "telephone_number": "706-367-7621",
            "fax_number": "706-367-2192"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUSAN WEAVER HAWN, MD, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-30",
        "last_updated": "2011-10-25",
        "status": "A",
        "authorized_official_last_name": "HAWN",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "706-367-7621",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "037562",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE NUMBER",
            "identifier": "037562",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00838318A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER NUMBER",
            "identifier": "702182",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GROUP NUMBER",
            "identifier": "00665",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.