Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213E00000X | Podiatrist | ||
N | 222Z00000X | Podiatrist | ||
N | 224P00000X | Prosthetist |
NPI | 1033239769 |
---|---|
Provider Name | Calvin K Hoyle |
First Address | Johnson City, TN 37601-1725 |
Second Address | Johnson City, TN 37601-1725 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/03/2007 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1455141 | (05) | TN |
4145147 | BSCBS OF TN (01) | TN |