Healthcare Provider Details

I. General information

NPI: 1932253994
Provider Name (Legal Business Name): ROBERT S. HOJNICKI D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/23/2007
Last Update Date: 01/11/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1812 E CRYSTAL CREEK DR
TERRE HAUTE IN
47802-4897
US

IV. Provider business mailing address

1812 E CRYSTAL CREEK DR
TERRE HAUTE IN
47802-4897
US

V. Phone/Fax

Practice location:
  • Phone: 812-299-9553
  • Fax: 775-414-5212
Mailing address:
  • Phone: 812-299-9553
  • Fax: 775-414-5212

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License Number02001114
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: