Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YX0905X | Otolaryngology/Facial Plastic Surgery | 31621 | MO |
NPI | 1558661116 |
---|---|
Provider Name | Dr. Willis H Hoyt III |
First Address | Jefferson City, MO 65110-4240 |
Second Address | Osage Beach, MO 65065-3016 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/10/2010 |
Last Update Date | 25/06/2012 |