Provider Demographics
NPI:1689690117
Name:HOADLEY, GERALD (PT, DPT)
Entity Type:Individual
Prefix:
First Name:GERALD
Middle Name:
Last Name:HOADLEY
Suffix:
Gender:M
Credentials:PT, DPT
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 179
Mailing Address - Street 2:
Mailing Address - City:FOREST HILL
Mailing Address - State:MD
Mailing Address - Zip Code:21050-0179
Mailing Address - Country:US
Mailing Address - Phone:410-838-6808
Mailing Address - Fax:410-838-2511
Practice Address - Street 1:12 NEWPORT DR
Practice Address - Street 2:SUITE A
Practice Address - City:FOREST HILL
Practice Address - State:MD
Practice Address - Zip Code:21050-1758
Practice Address - Country:US
Practice Address - Phone:410-838-6808
Practice Address - Fax:410-838-2511
Is Sole Proprietor?:No
Enumeration Date:2006-07-15
Last Update Date:2008-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD21002225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD621770OtherBCBS MD
MDQ09290Medicare UPIN
MD221MH671Medicare ID - Type Unspecified