Provider Demographics
NPI:1043220924
Name:HOSKINS, THOMAS H (PA)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:H
Last Name:HOSKINS
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1005 PENNSYLVANIA AVE
Mailing Address - Street 2:SUITE 212
Mailing Address - City:OTTUMWA
Mailing Address - State:IA
Mailing Address - Zip Code:52501-6413
Mailing Address - Country:US
Mailing Address - Phone:641-682-5443
Mailing Address - Fax:641-682-6859
Practice Address - Street 1:1005 PENNSYLVANIA AVE
Practice Address - Street 2:SUITE 212
Practice Address - City:OTTUMWA
Practice Address - State:IA
Practice Address - Zip Code:52501-6413
Practice Address - Country:US
Practice Address - Phone:641-682-5443
Practice Address - Fax:641-682-6859
Is Sole Proprietor?:No
Enumeration Date:2006-08-09
Last Update Date:2008-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPA10002355363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA239254OtherMIDLANDS CHOICE UPIN
IA71450OtherBCBS PIN
IAR12782Medicare UPIN
IAI21846Medicare PIN
IAP00444313Medicare PIN