Provider Demographics
NPI:1629528724
Name:HOXIE, THEODORE
Entity Type:Individual
Prefix:MR
First Name:THEODORE
Middle Name:
Last Name:HOXIE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:560 E M 55 LOT 33
Mailing Address - Street 2:
Mailing Address - City:TAWAS CITY
Mailing Address - State:MI
Mailing Address - Zip Code:48763-8102
Mailing Address - Country:US
Mailing Address - Phone:989-493-3519
Mailing Address - Fax:989-362-2880
Practice Address - Street 1:560 E M 55
Practice Address - Street 2:
Practice Address - City:TAWAS CITY
Practice Address - State:MI
Practice Address - Zip Code:48763-9227
Practice Address - Country:US
Practice Address - Phone:989-493-3519
Practice Address - Fax:989-362-2880
Is Sole Proprietor?:No
Enumeration Date:2016-10-12
Last Update Date:2016-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other