Provider Demographics
NPI:1558372771
Name:ROBERT HOSKINS, PLLC
Entity Type:Organization
Organization Name:ROBERT HOSKINS, PLLC
Other - Org Name:HOMETOWN CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:C
Authorized Official - Last Name:HOSKINS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:606-862-7000
Mailing Address - Street 1:PO BOX 2158
Mailing Address - Street 2:
Mailing Address - City:LONDON
Mailing Address - State:KY
Mailing Address - Zip Code:40743-2158
Mailing Address - Country:US
Mailing Address - Phone:606-862-7000
Mailing Address - Fax:606-864-1207
Practice Address - Street 1:22055 MAIN STREET
Practice Address - Street 2:STE 101
Practice Address - City:HYDEN
Practice Address - State:KY
Practice Address - Zip Code:41749
Practice Address - Country:US
Practice Address - Phone:606-672-7425
Practice Address - Fax:606-672-3077
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Not Answered363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY35-001742Medicaid
KY18-3930Medicare ID - Type UnspecifiedRHC
KY35-001742Medicaid