1053583443 NPI number — DR. BENJAMIN DAVID HOAGLAND MD

Table of content: DR. BENJAMIN DAVID HOAGLAND MD (NPI 1053583443)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1053583443 NPI number — DR. BENJAMIN DAVID HOAGLAND MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HOAGLAND
Provider First Name:
BENJAMIN
Provider Middle Name:
DAVID
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

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:
1053583443
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/17/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
ANDREWS MEDICAL GROUP - JOINT BASE ANDREWS
Provider Second Line Business Mailing Address:
BUILDING 1060, W. PERIMETER ROAD
Provider Business Mailing Address City Name:
JOINT BASE ANDREWS
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
20762
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
240-612-1650
Provider Business Mailing Address Fax Number:
240-612-2982

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
554 KEILY STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
JACKSONVILLE
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
32212-1312
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
757-953-7550
Provider Business Practice Location Address Fax Number:
757-953-7560
Provider Enumeration Date:
03/26/2008

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 208600000X , with the licence number:  0101255646 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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