Provider Demographics
NPI:1457389116
Name:HOSKINS, MARCUS E (PA-C)
Entity Type:Individual
Prefix:
First Name:MARCUS
Middle Name:E
Last Name:HOSKINS
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3031 HALCYON DR
Mailing Address - Street 2:
Mailing Address - City:BETTENDORF
Mailing Address - State:IA
Mailing Address - Zip Code:52722-3971
Mailing Address - Country:US
Mailing Address - Phone:563-332-6009
Mailing Address - Fax:
Practice Address - Street 1:4321 53RD AVE
Practice Address - Street 2:
Practice Address - City:BETTENDORF
Practice Address - State:IA
Practice Address - Zip Code:52722-1269
Practice Address - Country:US
Practice Address - Phone:563-421-5315
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-29
Last Update Date:2021-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ2883207P00000X
IA001720363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ102840Medicare ID - Type Unspecified
AZQ43507Medicare UPIN