Healthcare Provider Details

I. General information

NPI: 1518146257
Provider Name (Legal Business Name): SCOTT A HOTCHKISS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/30/2007
Last Update Date: 03/16/2023
Certification Date: 03/16/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1890 S US HIGHWAY 131
PETOSKEY MI
49770-8344
US

IV. Provider business mailing address

1890 S US HIGHWAY 131
PETOSKEY MI
49770-8344
US

V. Phone/Fax

Practice location:
  • Phone: 231-487-6000
  • Fax: 231-487-6014
Mailing address:
  • Phone: 231-487-6000
  • Fax: 231-487-6014

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number4301044355
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: