Provider Demographics
NPI:1538508320
Name:HITCHCOCK, ROBERT ARTHUR BRAZEAL (DO, PHD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:ARTHUR BRAZEAL
Last Name:HITCHCOCK
Suffix:
Gender:M
Credentials:DO, PHD
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 7247
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:OR
Mailing Address - Zip Code:97475-0011
Mailing Address - Country:US
Mailing Address - Phone:541-686-9551
Mailing Address - Fax:541-687-6716
Practice Address - Street 1:3333 RIVERBEND DR
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:OR
Practice Address - Zip Code:97477
Practice Address - Country:US
Practice Address - Phone:541-222-3154
Practice Address - Fax:541-222-3359
Is Sole Proprietor?:No
Enumeration Date:2013-06-14
Last Update Date:2019-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY04312207L00000X
IADO-04984207L00000X
ORDO192395207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology