Provider Demographics
NPI:1437177318
Name:HOY, KELLY JANE (OD)
Entity Type:Individual
Prefix:MS
First Name:KELLY
Middle Name:JANE
Last Name:HOY
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:KELLY
Other - Middle Name:J
Other - Last Name:HOY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:2750 MOUNT MORIAH PKWY
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38115-2063
Mailing Address - Country:US
Mailing Address - Phone:901-766-6742
Mailing Address - Fax:901-766-6743
Practice Address - Street 1:2750 MOUNT MORIAH PKWY
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38115-2063
Practice Address - Country:US
Practice Address - Phone:901-766-6742
Practice Address - Fax:901-766-6743
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2021-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1455152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
U41626Medicare UPIN
TN3598845Medicare ID - Type Unspecified