Provider Demographics
NPI:1083784557
Name:HOSEA, ROBERT HAYWOOD
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:HAYWOOD
Last Name:HOSEA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2001 STANTON RD
Mailing Address - Street 2:
Mailing Address - City:KINSTON
Mailing Address - State:NC
Mailing Address - Zip Code:28504-1423
Mailing Address - Country:US
Mailing Address - Phone:252-522-3958
Mailing Address - Fax:
Practice Address - Street 1:701 DOCTORS DR STE K
Practice Address - Street 2:
Practice Address - City:KINSTON
Practice Address - State:NC
Practice Address - Zip Code:28501-1584
Practice Address - Country:US
Practice Address - Phone:252-523-0687
Practice Address - Fax:252-523-0255
Is Sole Proprietor?:No
Enumeration Date:2006-11-09
Last Update Date:2010-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC22480207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC040008807OtherMEDICARE RAILROAD
NC8943940Medicaid
NC040008807OtherMEDICARE RAILROAD
NCC84581Medicare UPIN