Provider Demographics
NPI:1396751954
Name:HOEHN, ROBERT GARDELL (MD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:GARDELL
Last Name:HOEHN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 382321
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:38183-2321
Mailing Address - Country:US
Mailing Address - Phone:901-753-7700
Mailing Address - Fax:901-756-7038
Practice Address - Street 1:5100 POPLAR AVE STE 2222
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38137-2207
Practice Address - Country:US
Practice Address - Phone:901-753-7700
Practice Address - Fax:901-753-7038
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-01
Last Update Date:2024-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD00000208622084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN0197197OtherBLUE CROSSBLUE SHIELD
MS0114052Medicaid
TN3066810Medicaid
TN3066810Medicare ID - Type Unspecified
MS0114052Medicaid