Provider Demographics
NPI:1083994685
Name:HOYT, JEROD P (CRNA)
Entity Type:Individual
Prefix:
First Name:JEROD
Middle Name:P
Last Name:HOYT
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8801 S 101ST EAST AVE
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74133-5716
Mailing Address - Country:US
Mailing Address - Phone:918-294-4915
Mailing Address - Fax:918-294-4947
Practice Address - Street 1:8801 S 101ST EAST AVE
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74133-5716
Practice Address - Country:US
Practice Address - Phone:918-294-4915
Practice Address - Fax:918-294-4947
Is Sole Proprietor?:No
Enumeration Date:2011-08-26
Last Update Date:2017-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKR87903367500000X
TN22205367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered