MEDICARE: CALVIN K HOYLE CP, BOCO, C-PED

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	222Z00000X	Orthotist
2	224P00000X	Prosthetist

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	4145147	OTHER	TN	BSCBS OF TN

General Provider Information

NPI Number	:	1033239769
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CALVIN K HOYLE CP, BOCO, C-PED

Provider Business Mailing Address
First Line	:	2406 SUSANNAH ST
Second Line	:	LOWER LEVEL
City	:	JOHNSON CITY
State	:	TN
Zip	:	37601-1725
Country	:	US
Telephone Number	:	423-975-5462
Fax Number	:	423-975-5463

Provider Business Practice Location Address
First Line	:	2406 SUSANNAH ST
Second Line	:	LOWER LEVEL
City	:	JOHNSON CITY
State	:	TN
Zip	:	37601-1725
Country	:	US
Telephone Number	:	423-975-5462
Fax Number	:	423-975-5463

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/29/2007
Last Update Date	:	09/11/2025

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