Healthcare Provider Details
I. General information
NPI: 1811959166
Provider Name (Legal Business Name): ANDREW MARK HOELSCHER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 04/03/2006
Last Update Date: 11/13/2012
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
8105 NW EXPRESSWAY
OKLAHOMA CITY OK
73162-6004
US
IV. Provider business mailing address
8105 NW EXPRESSWAY
OKLAHOMA CITY OK
73162-6004
US
V. Phone/Fax
- Phone: 405-602-3500
- Fax: 405-602-3550
- Phone: 405-602-3500
- Fax: 405-602-3550
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207PE0004X |
| Taxonomy | Emergency Medical Services (Emergency Medicine) Physician |
| License Number | 18631 |
| License Number State | OK |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: