Basic Information
| Provider Information | |||||||||
| NPI: | 1619945698 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HAWKINSON | ||||||||
| FirstName: | MURRAY | ||||||||
| MiddleName: | GREY | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | LP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 284 EXECUTIVE PARK DR STE 100 | ||||||||
| Address2: | |||||||||
| City: | CONCORD | ||||||||
| State: | NC | ||||||||
| PostalCode: | 280251833 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7049391100 | ||||||||
| FaxNumber: | 7049391173 | ||||||||
| Practice Location | |||||||||
| Address1: | 132 POPLAR GROVE CONNECTOR STE B | ||||||||
| Address2: | |||||||||
| City: | BOONE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 286075915 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8282648759 | ||||||||
| FaxNumber: | 8282645860 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/08/2006 | ||||||||
| LastUpdateDate: | 07/22/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 07/22/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103T00000X | 1855 | NC | Y | Behavioral Health & Social Service Providers | Psychologist |
ID Information
| ID | Type | State | Issuer | Description | 03715 | 01 | NC | BCBS OF NC | OTHER | 03715 | 01 | NC | BCBS | OTHER | 104353 | 01 | NC | UNITED BEHAVIORAL HEALTH | OTHER | 96112 | 01 | NC | MEDCOST | OTHER | 787273-000 | 01 | NC | MAGELLAN | OTHER | 2814515C | 01 | NC | MEDICARE PTAN | OTHER | 6000733 | 05 | NC | MEDICAID |