Provider Demographics
NPI:1922342260
Name:LARRY S. HOTCHKISS, DPM, PC
Entity Type:Organization
Organization Name:LARRY S. HOTCHKISS, DPM, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LARRY
Authorized Official - Middle Name:S
Authorized Official - Last Name:HOTCHKISS
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:301-843-9582
Mailing Address - Street 1:12070 OLD LINE CTR
Mailing Address - Street 2:STE 110
Mailing Address - City:WALDORF
Mailing Address - State:MD
Mailing Address - Zip Code:20602-2513
Mailing Address - Country:US
Mailing Address - Phone:301-843-9582
Mailing Address - Fax:301-843-0921
Practice Address - Street 1:9135 PISCATAWAY RD
Practice Address - Street 2:STE 102
Practice Address - City:CLINTON
Practice Address - State:MD
Practice Address - Zip Code:20735-2549
Practice Address - Country:US
Practice Address - Phone:301-868-3899
Practice Address - Fax:301-868-3506
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-26
Last Update Date:2012-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD00370332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies