Provider Demographics
NPI:1508884453
Name:HOKE, BRENT KEVIN (DO)
Entity Type:Individual
Prefix:DR
First Name:BRENT
Middle Name:KEVIN
Last Name:HOKE
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:407 E RUSSELL AVE BLDG C
Mailing Address - Street 2:
Mailing Address - City:WARRENSBURG
Mailing Address - State:MO
Mailing Address - Zip Code:64093-1242
Mailing Address - Country:US
Mailing Address - Phone:660-747-5114
Mailing Address - Fax:660-747-5684
Practice Address - Street 1:407 E RUSSELL AVE BLDG C
Practice Address - Street 2:
Practice Address - City:WARRENSBURG
Practice Address - State:MO
Practice Address - Zip Code:64093-1242
Practice Address - Country:US
Practice Address - Phone:660-747-5114
Practice Address - Fax:660-747-5684
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR4J25207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO15389063OtherBLUE CROSS BLUE SHIELD KC
MO11060318OtherCAQH
MO4630453OtherAETNA NUMBER
MOT141155Medicare ID - Type UnspecifiedMEDICARE
MO15389063OtherBLUE CROSS BLUE SHIELD KC