Provider Demographics
NPI:1386688042
Name:HIOTT, JOANN (MD)
Entity Type:Individual
Prefix:
First Name:JOANN
Middle Name:
Last Name:HIOTT
Suffix:
Gender:F
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 751649
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28275-1649
Mailing Address - Country:US
Mailing Address - Phone:843-789-1620
Mailing Address - Fax:843-724-2440
Practice Address - Street 1:1879 SAVAGE RD
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29407-4726
Practice Address - Country:US
Practice Address - Phone:843-763-9472
Practice Address - Fax:843-763-7411
Is Sole Proprietor?:No
Enumeration Date:2006-06-15
Last Update Date:2020-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC13503207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCP00271466OtherRR MEDICARE
SC135035Medicaid
SC080180694OtherRR MEDICARE
SCD055129223Medicare PIN
SCD055126795Medicare PIN
SCD05512Medicare UPIN
SCP00271466OtherRR MEDICARE