Provider Demographics
NPI:1457870115
Name:HOERIG, JAMES STEPHEN (PA-C)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:STEPHEN
Last Name:HOERIG
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 1:320 PLAZA REAL APT 316
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33432-3950
Mailing Address - Country:US
Mailing Address - Phone:682-203-0457
Mailing Address - Fax:
Practice Address - Street 1:98 S FEDERAL HWY
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33432-4825
Practice Address - Country:US
Practice Address - Phone:561-368-0777
Practice Address - Fax:561-367-1300
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-13
Last Update Date:2017-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9110645207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine