Provider Demographics
NPI:1255403853
Name:HOAG, DANIEL B (DO)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:B
Last Name:HOAG
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 33269
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85067-3269
Mailing Address - Country:US
Mailing Address - Phone:602-406-4786
Mailing Address - Fax:916-636-4358
Practice Address - Street 1:20715 E OCOTILLO RD STE 102
Practice Address - Street 2:
Practice Address - City:QUEEN CREEK
Practice Address - State:AZ
Practice Address - Zip Code:85142-6118
Practice Address - Country:US
Practice Address - Phone:480-987-0987
Practice Address - Fax:480-987-0940
Is Sole Proprietor?:No
Enumeration Date:2006-11-15
Last Update Date:2024-11-12
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Provider Licenses
StateLicense IDTaxonomies
AZ3582207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ553504Medicaid
AZ553504Medicaid