Provider Demographics
NPI:1174569966
Name:HAWK, RAY WARNER (DC)
Entity type:Individual
Prefix:DR
First Name:RAY
Middle Name:WARNER
Last Name:HAWK
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10009 STATE LINE RD
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64114-4261
Mailing Address - Country:US
Mailing Address - Phone:816-942-5020
Mailing Address - Fax:816-943-1913
Practice Address - Street 1:10009 STATE LINE RD
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64114-4261
Practice Address - Country:US
Practice Address - Phone:816-942-5020
Practice Address - Fax:816-943-1913
Is Sole Proprietor?:No
Enumeration Date:2006-06-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO3712111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
0002977Medicare ID - Type Unspecified
MOT73668Medicare UPIN