Provider Demographics
NPI:1871788620
Name:HAWKEYE ORTHOPEDICS PA
Entity type:Organization
Organization Name:HAWKEYE ORTHOPEDICS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:G
Authorized Official - Last Name:KADOKO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:817-288-0084
Mailing Address - Street 1:2008 L DON DODSON DR
Mailing Address - Street 2:SUITE 110
Mailing Address - City:BEDFORD
Mailing Address - State:TX
Mailing Address - Zip Code:76021-5788
Mailing Address - Country:US
Mailing Address - Phone:817-288-0084
Mailing Address - Fax:817-445-1039
Practice Address - Street 1:2008 L DON DODSON DR
Practice Address - Street 2:SUITE 110
Practice Address - City:BEDFORD
Practice Address - State:TX
Practice Address - Zip Code:76021-5788
Practice Address - Country:US
Practice Address - Phone:817-288-0084
Practice Address - Fax:817-445-1039
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-13
Last Update Date:2009-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM1808174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty