Healthcare Provider Details

I. General information

NPI: 1689841025
Provider Name (Legal Business Name): THOMAS LEWIS HAMAGUCHI HOCKER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/14/2008
Last Update Date: 03/21/2023
Certification Date: 03/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6901 W 121ST ST
OVERLAND PARK KS
66209-2007
US

IV. Provider business mailing address

6901 W 121ST ST
OVERLAND PARK KS
66209-2007
US

V. Phone/Fax

Practice location:
  • Phone: 913-661-1755
  • Fax: 913-661-9260
Mailing address:
  • Phone: 913-661-1755
  • Fax: 913-661-9260

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number52239
License Number StateMN
# 2
Primary TaxonomyN
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number104499
License Number StateMN
# 3
Primary TaxonomyN
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number04-37477
License Number StateKS
# 4
Primary TaxonomyN
Taxonomy Code207ND0101X
TaxonomyMOHS-Micrographic Surgery Physician
License Number2022049288
License Number StateMO
# 5
Primary TaxonomyN
Taxonomy Code207ND0101X
TaxonomyMOHS-Micrographic Surgery Physician
License Number52239
License Number StateMN
# 6
Primary TaxonomyN
Taxonomy Code207ND0900X
TaxonomyDermatopathology Physician
License Number04-37477
License Number StateKS
# 7
Primary TaxonomyN
Taxonomy Code207ND0900X
TaxonomyDermatopathology Physician
License Number52239
License Number StateMN
# 8
Primary TaxonomyN
Taxonomy Code207NS0135X
TaxonomyProcedural Dermatology Physician
License Number52239
License Number StateMN
# 9
Primary TaxonomyY
Taxonomy Code207ND0101X
TaxonomyMOHS-Micrographic Surgery Physician
License Number04-37477
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: