Healthcare Provider Details

I. General information

NPI: 1376739722
Provider Name (Legal Business Name): GARY B. HOYT PSY.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/19/2007
Last Update Date: 09/19/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PSC 482 BOX 2577
FPO AP
96362
JP

IV. Provider business mailing address

PSC 482 BOX 2577
FPO AP
96362
JP

V. Phone/Fax

Practice location:
  • Phone: 6453009
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171000000X
TaxonomyMilitary Health Care Provider
License Number0810002689
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: