Provider Demographics
NPI:1376529453
Name:HOSPEL, THOMAS G (MD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:G
Last Name:HOSPEL
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 7527
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43017-0727
Mailing Address - Country:US
Mailing Address - Phone:614-544-6356
Mailing Address - Fax:614-544-6370
Practice Address - Street 1:6955 HOSPITAL DR
Practice Address - Street 2:MAX SPORTS MEDICINE
Practice Address - City:DUBLIN
Practice Address - State:OH
Practice Address - Zip Code:43016-8580
Practice Address - Country:US
Practice Address - Phone:614-566-1420
Practice Address - Fax:614-566-1429
Is Sole Proprietor?:No
Enumeration Date:2005-12-20
Last Update Date:2022-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35074828207QS0010X, 207Q00000X
OH35-074828207QS0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2925820Medicaid
OHG46349Medicare UPIN
G46349Medicare UPIN
OHHO4030851Medicare ID - Type Unspecified
OH4030852Medicare PIN