Healthcare Provider Details

I. General information

NPI: 1740280619
Provider Name (Legal Business Name): EDWARD E HOSBACH II D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/21/2005
Last Update Date: 10/09/2025
Certification Date: 10/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1830 UNION CITY RD
FT RECOVERY OH
45846-9315
US

IV. Provider business mailing address

830 W MAIN ST
COLDWATER OH
45828-1626
US

V. Phone/Fax

Practice location:
  • Phone: 419-375-4144
  • Fax: 419-375-4361
Mailing address:
  • Phone: 567-890-7143
  • Fax: 419-586-0812

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number34 004555
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number02002043
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: