MEDICARE: DR. MARK HOEPRICH M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207T00000X	Neurological Surgery Physician	01097713A	IN
2	207T00000X	Neurological Surgery Physician	4301086032	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1073714457
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARK HOEPRICH M.D.

Provider Business Mailing Address
First Line	:	3700 SOUTHERN BLVD STE 300
Second Line	:
City	:	KETTERING
State	:	OH
Zip	:	45429-1265
Country	:	US
Telephone Number	:	937-643-9299
Fax Number	:	937-643-2343

Provider Business Practice Location Address
First Line	:	3700 SOUTHERN BLVD STE 300
Second Line	:
City	:	KETTERING
State	:	OH
Zip	:	45429
Country	:	US
Telephone Number	:	937-643-9299
Fax Number	:	937-643-2343

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/31/2007
Last Update Date	:	03/04/2026

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