Healthcare Provider Details

I. General information

NPI: 1902023344
Provider Name (Legal Business Name): JOEL BENJAMIN HOAG M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/19/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

321 SUNSET DR SE
CALHOUN GA
30701-4642
US

IV. Provider business mailing address

321 SUNSET DR SE
CALHOUN GA
30701-4642
US

V. Phone/Fax

Practice location:
  • Phone: 706-625-1261
  • Fax: 706-602-8105
Mailing address:
  • Phone: 706-625-1261
  • Fax: 706-602-8105

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number016611
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: