1063433217 NPI number — HOCKMAN & ASSOCIATES LLC

Table of content: (NPI 1063433217)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1063433217 NPI number — HOCKMAN & ASSOCIATES LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HOCKMAN & ASSOCIATES LLC
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:
HOCKMAN & ASSOCIATES OB/GYN
Provider Other Organization Name Type Code:
3
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:
1063433217
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/21/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 11447
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GREEN BAY
Provider Business Mailing Address State Name:
WI
Provider Business Mailing Address Postal Code:
54307-1447
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
920-609-2045
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
835 S MAIN ST
Provider Second Line Business Practice Location Address:
SUITE # 2
Provider Business Practice Location Address City Name:
OCONTO FALLS
Provider Business Practice Location Address State Name:
WI
Provider Business Practice Location Address Postal Code:
54154-1282
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
920-609-2045
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/22/2006

Additional Information

Authorized Official

Authorized Official Last Name:
HOCKMAN
Authorized Official First Name:
SHEILA
Authorized Official Middle Name:
FAYE
Authorized Official Title or Position:
PHYSICIAN/OWNER
Authorized Official Telephone Number:
920-737-3430

Provider Taxonomy Codes

  • Taxonomy code: 207V00000X , with the licence number:  44114 , registered in the state of WI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 43506500 , issued by the state of ( WI ) . This identifiers is of the category "MEDICAID".




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