Provider Demographics
NPI:1497843882
Name:HOTCHKISS, ROBERT KENNETH (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:KENNETH
Last Name:HOTCHKISS
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:P.O. BOX 50337
Mailing Address - Street 2:
Mailing Address - City:MYRTLE BEACH
Mailing Address - State:SC
Mailing Address - Zip Code:29579-0006
Mailing Address - Country:US
Mailing Address - Phone:843-997-3111
Mailing Address - Fax:877-804-3446
Practice Address - Street 1:607 W EVANS ST
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:SC
Practice Address - Zip Code:29501-3409
Practice Address - Country:US
Practice Address - Phone:843-997-3111
Practice Address - Fax:877-804-3446
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-10
Last Update Date:2013-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC132612084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC327877Medicaid
SC132617Medicaid
SC3344Medicare UPIN
SC132617Medicaid
SCB914860Medicare UPIN