Provider Demographics
NPI:1891803243
Name:HOTT, KIMBERLY ANNE (MD)
Entity Type:Individual
Prefix:DR
First Name:KIMBERLY
Middle Name:ANNE
Last Name:HOTT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:116 GREENTREE DR
Mailing Address - Street 2:
Mailing Address - City:CRAWFORD
Mailing Address - State:TX
Mailing Address - Zip Code:76638-2770
Mailing Address - Country:US
Mailing Address - Phone:254-848-4095
Mailing Address - Fax:
Practice Address - Street 1:3000 HERRING AVE
Practice Address - Street 2:
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76708-3239
Practice Address - Country:US
Practice Address - Phone:254-202-8611
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL4447207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
E18727Medicare UPIN