Healthcare Provider Details

I. General information

NPI: 1578549580
Provider Name (Legal Business Name): CLINT HOXIE O.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/21/2005
Last Update Date: 07/25/2026
Certification Date: 07/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31205 BLUE SPRUCE DR
POLSON MT
59860-9187
US

IV. Provider business mailing address

31205 BLUE SPRUCE DR
POLSON MT
59860-9187
US

V. Phone/Fax

Practice location:
  • Phone: 406-871-3581
  • Fax:
Mailing address:
  • Phone: 406-871-3581
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberOPT-OPT-LIC-752
License Number StateMT
# 2
Primary TaxonomyN
Taxonomy Code152WC0802X
TaxonomyCorneal and Contact Management Optometrist
License Number752
License Number StateMT
# 3
Primary TaxonomyN
Taxonomy Code152WP0200X
TaxonomyPediatric Optometrist
License Number752
License Number StateMT
# 4
Primary TaxonomyN
Taxonomy Code152WV0400X
TaxonomyVision Therapy Optometrist
License Number752
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: