Provider Demographics
NPI:1336141811
Name:HOYNES, SEAN D (MD)
Entity Type:Individual
Prefix:
First Name:SEAN
Middle Name:D
Last Name:HOYNES
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 8792
Mailing Address - Street 2:
Mailing Address - City:BELFAST
Mailing Address - State:ME
Mailing Address - Zip Code:04915-8792
Mailing Address - Country:US
Mailing Address - Phone:330-239-4455
Mailing Address - Fax:330-239-4456
Practice Address - Street 1:5133 RIDGE RD # 1
Practice Address - Street 2:
Practice Address - City:WADSWORTH
Practice Address - State:OH
Practice Address - Zip Code:44281-9708
Practice Address - Country:US
Practice Address - Phone:330-239-4455
Practice Address - Fax:330-239-4456
Is Sole Proprietor?:No
Enumeration Date:2005-08-15
Last Update Date:2020-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35066974207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0114487Medicaid
OH0114487Medicaid