Provider Demographics
NPI:1609962075
Name:HOEGH, JAMES EDWARD (MS, PT)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:EDWARD
Last Name:HOEGH
Suffix:
Gender:M
Credentials:MS, PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:333 N 11TH ST
Mailing Address - Street 2:
Mailing Address - City:SUNBURY
Mailing Address - State:PA
Mailing Address - Zip Code:17801-1610
Mailing Address - Country:US
Mailing Address - Phone:570-847-2474
Mailing Address - Fax:
Practice Address - Street 1:333 N 11TH ST
Practice Address - Street 2:
Practice Address - City:SUNBURY
Practice Address - State:PA
Practice Address - Zip Code:17801-1610
Practice Address - Country:US
Practice Address - Phone:570-847-2474
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-05
Last Update Date:2009-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT010694L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA133288OtherHEALTH AMER/HEALTH ASSUR.
PA02035101OtherCAPITAL/KHPC
PAH0680542OtherHIGHMARK BLUE SHIELD
PA7018703OtherAETNA
PA396749Medicare ID - Type UnspecifiedMEDICARE