MEDICARE: WARREN EUGENE HOSKINS II LPA

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	103T00000X	Psychologist	5111	NC

General Provider Information

NPI Number	:	1053843532
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WARREN EUGENE HOSKINS II LPA

Provider Business Mailing Address
First Line	:	3379 TARLETON W
Second Line	:
City	:	DURHAM
State	:	NC
Zip	:	27713-5404
Country	:	US
Telephone Number	:	704-369-1771
Fax Number	:

Provider Business Practice Location Address
First Line	:	2530 MERIDIAN PKWY # 3104
Second Line	:
City	:	DURHAM
State	:	NC
Zip	:	27713-5272
Country	:	US
Telephone Number	:	984-400-4823
Fax Number	:

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

Provider Enumeration Date	:	04/03/2017
Last Update Date	:	12/20/2021

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