Provider Demographics
NPI:1043209984
Name:HOYT, JONATHAN L (MD)
Entity Type:Individual
Prefix:
First Name:JONATHAN
Middle Name:L
Last Name:HOYT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:145 HIGHWAY 71 N
Mailing Address - Street 2:DE QUEEN
Mailing Address - City:DE QUEEN
Mailing Address - State:AR
Mailing Address - Zip Code:71832-3706
Mailing Address - Country:US
Mailing Address - Phone:870-642-5600
Mailing Address - Fax:
Practice Address - Street 1:145 HIGHWAY 71 N
Practice Address - Street 2:DE QUEEN
Practice Address - City:DE QUEEN
Practice Address - State:AR
Practice Address - Zip Code:71832-3706
Practice Address - Country:US
Practice Address - Phone:870-642-5600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-13
Last Update Date:2010-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARC6426207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR112254001Medicaid
AR51078OtherBCBS
AR51078OtherBCBS
AR51078Medicare ID - Type Unspecified