MEDICARE: ANDREW HOBECK OD

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	390200000X	Student in an Organized Health Care Education/Training Program
2	152W00000X	Optometrist	2024023445	MO

General Provider Information

NPI Number	:	1770363855
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANDREW HOBECK OD

Provider Business Mailing Address
First Line	:	3140 BLATTNER DR
Second Line	:
City	:	CAPE GIRARDEAU
State	:	MO
Zip	:	63703-6348
Country	:	US
Telephone Number	:	573-334-2020
Fax Number	:	573-334-2915

Provider Business Practice Location Address
First Line	:	3140 BLATTNER DR
Second Line	:
City	:	CAPE GIRARDEAU
State	:	MO
Zip	:	63703-6348
Country	:	US
Telephone Number	:	573-334-2020
Fax Number	:	573-334-2915

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

Provider Enumeration Date	:	10/04/2023
Last Update Date	:	06/26/2024

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