Provider Demographics
NPI:1861488033
Name:HOTCHKISS, MARK J (MD)
Entity Type:Individual
Prefix:
First Name:MARK
Middle Name:J
Last Name:HOTCHKISS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:240 INDIAN RIVER ROAD
Mailing Address - Street 2:SUITE A5
Mailing Address - City:ORANGE
Mailing Address - State:CT
Mailing Address - Zip Code:06477-3649
Mailing Address - Country:US
Mailing Address - Phone:203-799-1252
Mailing Address - Fax:203-799-3252
Practice Address - Street 1:240 INDIAN RIVER ROAD
Practice Address - Street 2:SUITE A5
Practice Address - City:ORANGE
Practice Address - State:CT
Practice Address - Zip Code:06477
Practice Address - Country:US
Practice Address - Phone:203-799-1252
Practice Address - Fax:203-799-3252
Is Sole Proprietor?:No
Enumeration Date:2005-09-23
Last Update Date:2021-05-27
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Provider Licenses
StateLicense IDTaxonomies
CT34345207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT001343459Medicaid
CTD400000906Medicare PIN
G01635Medicare UPIN
CT001343459Medicaid
CTD400102432Medicare PIN
CT390000204Medicare PIN