Provider Demographics
NPI:1033239769
Name:HOYLE, CALVIN K (CP, BOCO, C-PED)
Entity Type:Individual
Prefix:
First Name:CALVIN
Middle Name:K
Last Name:HOYLE
Suffix:
Gender:M
Credentials:CP, BOCO, C-PED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2406 SUSANNAH ST
Mailing Address - Street 2:LOWER LEVEL
Mailing Address - City:JOHNSON CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37601-1725
Mailing Address - Country:US
Mailing Address - Phone:423-975-5462
Mailing Address - Fax:423-975-5463
Practice Address - Street 1:2406 SUSANNAH ST
Practice Address - Street 2:LOWER LEVEL
Practice Address - City:JOHNSON CITY
Practice Address - State:TN
Practice Address - Zip Code:37601-1725
Practice Address - Country:US
Practice Address - Phone:423-975-5462
Practice Address - Fax:423-975-5463
Is Sole Proprietor?:No
Enumeration Date:2007-03-29
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotist
Not Answered224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1455141Medicaid
TN4145147OtherBSCBS OF TN
TN1455141Medicaid