Provider Demographics
NPI:1740260561
Name:HOECKER, LANDON S (MD)
Entity type:Individual
Prefix:
First Name:LANDON
Middle Name:S
Last Name:HOECKER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7150 E CAMELBACK RD
Mailing Address - Street 2:SUITE 105
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85251-1200
Mailing Address - Country:US
Mailing Address - Phone:602-218-4072
Mailing Address - Fax:602-218-4076
Practice Address - Street 1:7150 E CAMELBACK RD
Practice Address - Street 2:SUITE 105
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85251-1200
Practice Address - Country:US
Practice Address - Phone:602-218-4072
Practice Address - Fax:602-218-4076
Is Sole Proprietor?:No
Enumeration Date:2006-01-18
Last Update Date:2015-08-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ30150207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ692774Medicaid
AZ692774Medicaid
AZ692774Medicaid