Provider Demographics
NPI:1477726354
Name:WHITTEN-HOSKINS, ELIZA JOYCE (MD)
Entity type:Individual
Prefix:
First Name:ELIZA
Middle Name:JOYCE
Last Name:WHITTEN-HOSKINS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1189 SANDSTREAM CT
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37042-8781
Mailing Address - Country:US
Mailing Address - Phone:931-217-0831
Mailing Address - Fax:
Practice Address - Street 1:105 KEETON DR
Practice Address - Street 2:
Practice Address - City:HOPKINSVILLE
Practice Address - State:KY
Practice Address - Zip Code:42240-8756
Practice Address - Country:US
Practice Address - Phone:270-887-6565
Practice Address - Fax:270-887-6575
Is Sole Proprietor?:No
Enumeration Date:2008-04-10
Last Update Date:2025-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN46881208000000X
KY52035208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1525188Medicaid
KY7100562310Medicaid
TN4281374OtherBLUE CROSS BLUE SHIELD
KY7100562310Medicaid
TN1525188Medicaid
9201647OtherAETNA