Provider Demographics
NPI:1003520651
Name:HOEZEE, ADDY (PA-C)
Entity Type:Individual
Prefix:
First Name:ADDY
Middle Name:
Last Name:HOEZEE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 CONCOURSE PKWY STE 240
Mailing Address - Street 2:
Mailing Address - City:HOOVER
Mailing Address - State:AL
Mailing Address - Zip Code:35244-1857
Mailing Address - Country:US
Mailing Address - Phone:205-721-9958
Mailing Address - Fax:
Practice Address - Street 1:100 CONCOURSE PKWY STE 265
Practice Address - Street 2:
Practice Address - City:HOOVER
Practice Address - State:AL
Practice Address - Zip Code:35244-2904
Practice Address - Country:US
Practice Address - Phone:205-721-9958
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-09
Last Update Date:2023-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPA.2074363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant