Provider Demographics
NPI:1528047099
Name:HOEHN, PHILIP ALLEN (PT)
Entity type:Individual
Prefix:
First Name:PHILIP
Middle Name:ALLEN
Last Name:HOEHN
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23990 STATELINE RD
Mailing Address - Street 2:STE 1
Mailing Address - City:LAWRENCEBURG
Mailing Address - State:IN
Mailing Address - Zip Code:47025
Mailing Address - Country:US
Mailing Address - Phone:812-637-6222
Mailing Address - Fax:812-637-6225
Practice Address - Street 1:23990 STATELINE RD
Practice Address - Street 2:STE 1
Practice Address - City:LAWRENCEBURG
Practice Address - State:IN
Practice Address - Zip Code:47025
Practice Address - Country:US
Practice Address - Phone:812-637-6222
Practice Address - Fax:812-637-6225
Is Sole Proprietor?:No
Enumeration Date:2006-01-12
Last Update Date:2011-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN05004687A225100000X
OHPT004914225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
31233OtherANTHEM
29842OtherANTHEM FOR SEI PHYSICAL T
IN200163540AMedicaid
172850AMedicare ID - Type Unspecified