Provider Demographics
NPI:1225167901
Name:HOJNICKI, DORENE G (DO)
Entity Type:Individual
Prefix:DR
First Name:DORENE
Middle Name:G
Last Name:HOJNICKI
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1812 E CRYSTAL CREEK DR
Mailing Address - Street 2:
Mailing Address - City:TERRE HAUTE
Mailing Address - State:IN
Mailing Address - Zip Code:47802-4897
Mailing Address - Country:US
Mailing Address - Phone:812-299-9553
Mailing Address - Fax:
Practice Address - Street 1:915 S PETERCHEFF ST
Practice Address - Street 2:
Practice Address - City:TERRE HAUTE
Practice Address - State:IN
Practice Address - Zip Code:47803-5027
Practice Address - Country:US
Practice Address - Phone:812-462-3217
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-05
Last Update Date:2010-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN02001051207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
INE30267Medicare UPIN