Provider Demographics
NPI:1902023344
Name:HOAG, JOEL BENJAMIN (MD)
Entity Type:Individual
Prefix:DR
First Name:JOEL
Middle Name:BENJAMIN
Last Name:HOAG
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 1:321 SUNSET DR SE
Mailing Address - Street 2:
Mailing Address - City:CALHOUN
Mailing Address - State:GA
Mailing Address - Zip Code:30701-4642
Mailing Address - Country:US
Mailing Address - Phone:706-625-1261
Mailing Address - Fax:706-602-8105
Practice Address - Street 1:321 SUNSET DR SE
Practice Address - Street 2:
Practice Address - City:CALHOUN
Practice Address - State:GA
Practice Address - Zip Code:30701-4642
Practice Address - Country:US
Practice Address - Phone:706-625-1261
Practice Address - Fax:706-602-8105
Is Sole Proprietor?:No
Enumeration Date:2007-04-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA016611207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAD10110Medicare UPIN