Provider Demographics
NPI:1871583815
Name:HOECK, JEFFERY T (MD)
Entity type:Individual
Prefix:DR
First Name:JEFFERY
Middle Name:T
Last Name:HOECK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 8745
Mailing Address - Street 2:
Mailing Address - City:BELFAST
Mailing Address - State:ME
Mailing Address - Zip Code:04915-8745
Mailing Address - Country:US
Mailing Address - Phone:443-481-6566
Mailing Address - Fax:443-481-6515
Practice Address - Street 1:4175 N HANSON CT
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20716-3179
Practice Address - Country:US
Practice Address - Phone:410-741-1519
Practice Address - Fax:301-464-9383
Is Sole Proprietor?:No
Enumeration Date:2005-10-21
Last Update Date:2010-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0058289207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD400681000Medicaid
MD61661501OtherBCBS
2917287OtherAETNA
DC56710002OtherBCBS
5540433OtherAETNA
151MD500Medicare PIN
DC56710002OtherBCBS
MD61661501OtherBCBS