Provider Demographics
NPI:1609850957
Name:HOEHNE, TERRY GLENN (MD)
Entity Type:Individual
Prefix:
First Name:TERRY
Middle Name:GLENN
Last Name:HOEHNE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:6207 S WEST SHORE BLVD APT 2070
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33616-1654
Mailing Address - Country:US
Mailing Address - Phone:314-369-7509
Mailing Address - Fax:
Practice Address - Street 1:3250 ZEMKE AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33621-5023
Practice Address - Country:US
Practice Address - Phone:813-827-9708
Practice Address - Fax:813-827-1512
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-30
Last Update Date:2023-06-15
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MOR3P23207Q00000X, 2083A0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083A0100XAllopathic & Osteopathic PhysiciansPreventive MedicineAerospace Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILOTH000Medicare UPIN