Provider Demographics
NPI:1689841025
Name:HOCKER, THOMAS LEWIS HAMAGUCHI (MD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:LEWIS HAMAGUCHI
Last Name:HOCKER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6901 W 121ST ST
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66209-2007
Mailing Address - Country:US
Mailing Address - Phone:913-661-1755
Mailing Address - Fax:913-661-9260
Practice Address - Street 1:6901 W 121ST ST
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66209-2007
Practice Address - Country:US
Practice Address - Phone:913-661-1755
Practice Address - Fax:913-661-9260
Is Sole Proprietor?:No
Enumeration Date:2008-05-14
Last Update Date:2023-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN52239207N00000X, 207ND0101X, 207ND0900X, 207NS0135X
MN104499207N00000X
KS04-37477207N00000X, 207ND0900X, 207ND0101X
MO2022049288207ND0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic Surgery
No207N00000XAllopathic & Osteopathic PhysiciansDermatology
No207ND0900XAllopathic & Osteopathic PhysiciansDermatologyDermatopathology
No207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural Dermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KSP00804295OtherMEDICARE RAILROAD
KSP00804295OtherMEDICARE RAILROAD
IAENROLLEDMedicaid
MNENROLLEDMedicaid