1124132147 NPI number — LARRY S. HOTCHKISS, DPM PC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1124132147 NPI number — LARRY S. HOTCHKISS, DPM PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
LARRY S. HOTCHKISS, DPM PC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1124132147
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/17/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
9135 PISCATAWAY RD STE 102
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CLINTON
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
20735-2548
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
301-868-6778
Provider Business Mailing Address Fax Number:
301-868-3506

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9135 PISCATAWAY RD
Provider Second Line Business Practice Location Address:
STE 102
Provider Business Practice Location Address City Name:
CLINTON
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
20735-2549
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
301-868-6778
Provider Business Practice Location Address Fax Number:
301-868-3506
Provider Enumeration Date:
08/18/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
HOTCHKISS
Authorized Official First Name:
LARRY
Authorized Official Middle Name:
STEPHAN
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
301-868-6778

Provider Taxonomy Codes

  • Taxonomy code: 213ES0103X , with the licence number:  00370 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)