Charles Hoyt Ii, | |
460 Tennessee St Apt 306, Memphis, TN 38103-4484 | |
(512) 825-1810 | |
Not Available |
Full Name | Charles Hoyt Ii |
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Gender | Male |
Speciality | Nurse Anesthetist, Certified Registered |
Location | 460 Tennessee St Apt 306, Memphis, Tennessee |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1619563947 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
163W00000X | Registered Nurse | 000022863 (Tennessee) | Secondary |
367500000X | Nurse Anesthetist, Certified Registered | 10007858 (Oregon) | Primary |
Entity Name | Kaiser Foundation Health Plan Of The Northwest |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1184786527 PECOS PAC ID: 5799688230 Enrollment ID: O20040130000799 |
Mailing Address | Practice Location Address |
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Charles Hoyt Ii, 420 Monroe Ave Apt 1107, Memphis, TN 38103-3252 Ph: () - | Charles Hoyt Ii, 460 Tennessee St Apt 306, Memphis, TN 38103-4484 Ph: (512) 825-1810 |
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