Provider Demographics
NPI:1275525123
Name:HOERNER, THOMAS EARL (MD)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:EARL
Last Name:HOERNER
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 1:16 PELHAM RD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:SALEM
Mailing Address - State:NH
Mailing Address - Zip Code:03079-2826
Mailing Address - Country:US
Mailing Address - Phone:603-898-2244
Mailing Address - Fax:603-898-2227
Practice Address - Street 1:16 PELHAM RD
Practice Address - Street 2:SUITE 1
Practice Address - City:SALEM
Practice Address - State:NH
Practice Address - Zip Code:03079-2826
Practice Address - Country:US
Practice Address - Phone:603-898-2244
Practice Address - Fax:603-898-2227
Is Sole Proprietor?:No
Enumeration Date:2005-08-17
Last Update Date:2008-03-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA45093207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3166627Medicaid
MA3166627Medicaid
MAA56294Medicare UPIN