Provider Demographics
NPI:1326017203
Name:HOYER, SCOTT WILLIAM (MD)
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:WILLIAM
Last Name:HOYER
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:PO BOX 5545
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:IN
Mailing Address - Zip Code:47903-5545
Mailing Address - Country:US
Mailing Address - Phone:765-448-8000
Mailing Address - Fax:
Practice Address - Street 1:2600 FERRY ST
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:IN
Practice Address - Zip Code:47904-3055
Practice Address - Country:US
Practice Address - Phone:765-448-8000
Practice Address - Fax:765-448-7612
Is Sole Proprietor?:No
Enumeration Date:2006-03-14
Last Update Date:2012-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01035989A2084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000181624OtherANTHEM PROVIDER NUMBER
IN10825297OtherCAQH NUMBER
IN9041612OtherPHCS PID NUMBER
INHO15252013Medicaid
IN10085130Medicaid
IN10085130Medicaid
IN815510NNMedicare PIN
IN130017878Medicare PIN
IN10825297OtherCAQH NUMBER
IN815520RRMedicare PIN
IN9041612OtherPHCS PID NUMBER
IN142080CCCMedicare PIN
INHO15252013Medicaid