OrganizationHawthorne Medical Associates PcInternal MedicineAllopathic & Osteopathic PhysiciansPractice Address120 Hawthorne Park, Athens, GA 30606-2147(706) 353-8700PECOS EnrollmentBased on the most recent information from CMS, provider Hawthorne Medical Associates Pc does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1689636201Provider TypeOrganizationFull NameHawthorne Medical Associates PcSubpartNoEnumeration Date4/6/2006Last Updated2/15/2010Contact InformationPractice LocationPractice Address120 Hawthorne Park, Athens, GA 30606-2147Phone(706) 353-8700Fax(706) 353-7228Mailing LocationMailing Address120 Hawthorne Park, Athens, GA 30606-2147Phone(706) 353-8700Fax(706) 353-7228Authorized OfficialNameDes Jardines, Shelley D (Practice Administrator)Phone(706) 769-3331Provider TaxonomiesCodeDescriptionLicenseCode207R00000XPrimaryDescriptionInternal MedicineAllopathic & Osteopathic PhysiciansLicenseUnlisted IssuerProvider IdentifiersIDDescriptionIssuerIDCC3389DescriptionOtherIssuerRAILROAD MEDICAREGeorgiaID06965DescriptionOtherIssuerBLUE CROSS/BLUE SHIELDGeorgia