Healthcare Provider Details

I. General information

NPI: 1083351522
Provider Name (Legal Business Name): LAURA CAROLYN HOCKEY MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: LAURA CAROLYN HOCKEY

II. Dates (important events)

Enumeration Date: 05/17/2022
Last Update Date: 06/28/2025
Certification Date: 06/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2109 HUGHES DR FL 3
TOLEDO OH
43606-3856
US

IV. Provider business mailing address

608 UNION CHAPEL RD
FORT WAYNE IN
46845-9357
US

V. Phone/Fax

Practice location:
  • Phone: 419-291-8154
  • Fax:
Mailing address:
  • Phone: 216-571-4930
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number35.151770
License Number StateOH
# 3
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number01096307A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: