Provider Demographics
NPI:1942484969
Name:HOEHNS, JAMES D (PHARMD, BCPS)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:D
Last Name:HOEHNS
Suffix:
Gender:M
Credentials:PHARMD, BCPS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2055 KIMBALL AVENUE
Mailing Address - Street 2:NORTHEAST IOWA MEDICAL EDUCATION FOUNDATION
Mailing Address - City:WATERLOO
Mailing Address - State:IA
Mailing Address - Zip Code:50702
Mailing Address - Country:US
Mailing Address - Phone:319-272-2533
Mailing Address - Fax:319-272-1844
Practice Address - Street 1:2055 KIMBALL AVE
Practice Address - Street 2:
Practice Address - City:WATERLOO
Practice Address - State:IA
Practice Address - Zip Code:50702-5014
Practice Address - Country:US
Practice Address - Phone:319-272-2533
Practice Address - Fax:319-272-1844
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-27
Last Update Date:2007-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA178391835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0012823Medicaid