Provider Demographics
NPI:1285628396
Name:HOHM, RICHARD A (MD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:A
Last Name:HOHM
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 1:1217 RIVERSIDE AVE
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80524-3218
Mailing Address - Country:US
Mailing Address - Phone:970-490-2662
Mailing Address - Fax:970-490-2909
Practice Address - Street 1:1217 RIVERSIDE AVE
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80524-3218
Practice Address - Country:US
Practice Address - Phone:970-490-2662
Practice Address - Fax:970-490-2909
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-02
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO20609208600000X, 2086S0120X, 2086S0129X, 2086X0206X, 208C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered208600000XAllopathic & Osteopathic PhysiciansSurgery
Not Answered2086S0120XAllopathic & Osteopathic PhysiciansSurgeryPediatric Surgery
Not Answered2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Not Answered2086X0206XAllopathic & Osteopathic PhysiciansSurgerySurgical Oncology
Not Answered208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
3158344004OtherCIGNA ID
CO01206093Medicaid
3158344003OtherCIGNA ID
CO31988OtherANTHEM BCBS
5324338OtherAETNA ID
NE841514692-00Medicaid
CO841514692-04OtherPACIFICARE
TX0612012Medicaid
NE841514692-00Medicaid
CO841514692-04OtherPACIFICARE