Provider Demographics
NPI:1811959166
Name:HOELSCHER, ANDREW MARK (MD)
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:MARK
Last Name:HOELSCHER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:DREW
Other - Middle Name:
Other - Last Name:HOELSCHER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:8105 NW EXPRESSWAY
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73162-6004
Mailing Address - Country:US
Mailing Address - Phone:405-602-3500
Mailing Address - Fax:405-602-3550
Practice Address - Street 1:8105 NW EXPRESSWAY
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73162-6004
Practice Address - Country:US
Practice Address - Phone:405-602-3500
Practice Address - Fax:405-602-3550
Is Sole Proprietor?:No
Enumeration Date:2006-04-03
Last Update Date:2012-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK18631207PE0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK930054790OtherRR MEDICARE
OK100148180BMedicaid
OK100148180AMedicaid
OK244234508Medicare ID - Type Unspecified
OKF69409Medicare UPIN
OK100148180AMedicaid