Healthcare Provider Details

I. General information

NPI: 1811308539
Provider Name (Legal Business Name): THOMAS CARLTON HOAK JR. M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/15/2014
Last Update Date: 05/15/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4440 N OLIVE AVE
TURLOCK CA
95382-8313
US

IV. Provider business mailing address

4440 N OLIVE AVE
TURLOCK CA
95382-8313
US

V. Phone/Fax

Practice location:
  • Phone: 209-632-3842
  • Fax:
Mailing address:
  • Phone: 209-632-3842
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberG79434
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: