Provider Demographics
NPI:1346670056
Name:HOKETT, MARK HILL (PA-C)
Entity Type:Individual
Prefix:
First Name:MARK
Middle Name:HILL
Last Name:HOKETT
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:920 BACKWOODS RD
Mailing Address - Street 2:
Mailing Address - City:CEDARCREEK
Mailing Address - State:MO
Mailing Address - Zip Code:65627-9367
Mailing Address - Country:US
Mailing Address - Phone:281-802-7269
Mailing Address - Fax:
Practice Address - Street 1:920 BACKWOODS RD
Practice Address - Street 2:
Practice Address - City:CEDARCREEK
Practice Address - State:MO
Practice Address - Zip Code:65627-9367
Practice Address - Country:US
Practice Address - Phone:281-802-7269
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-11-15
Last Update Date:2024-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2017032072363A00000X
NC0010-07531363A00000X
CAPA51281363A00000X
TXPA11506363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant