Healthcare Provider Details

I. General information

NPI: 1629020078
Provider Name (Legal Business Name): WILLIAM ENLOE HOKE JR. M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/16/2006
Last Update Date: 03/20/2020
Certification Date: 03/20/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1454 MARKET ST
CHARLESTOWN IN
47111-1839
US

IV. Provider business mailing address

1454 MARKET ST
CHARLESTOWN IN
47111-1839
US

V. Phone/Fax

Practice location:
  • Phone: 812-503-5071
  • Fax: 812-503-5076
Mailing address:
  • Phone: 812-503-5071
  • Fax: 812-503-5076

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number39527
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number01061465A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: