Basic Information
| Provider Information | |||||||||
| NPI: | 1033199708 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HOTCHKISS | ||||||||
| FirstName: | JEROME | ||||||||
| MiddleName: | J | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | JR. | ||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1380 LITTLE SORRELL DR STE 100 | ||||||||
| Address2: | |||||||||
| City: | HARRISONBURG | ||||||||
| State: | VA | ||||||||
| PostalCode: | 228017372 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5404334913 | ||||||||
| FaxNumber: | 5404334915 | ||||||||
| Practice Location | |||||||||
| Address1: | 1380 LITTLE SORRELL DR STE 100 | ||||||||
| Address2: | |||||||||
| City: | HARRISONBURG | ||||||||
| State: | VA | ||||||||
| PostalCode: | 22801 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5404334913 | ||||||||
| FaxNumber: | 5404334915 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/19/2006 | ||||||||
| LastUpdateDate: | 10/15/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 0101-222143 | VA | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 6447399 | 01 | VA | CIGNA | OTHER | 1000870001 | 01 | VA | DME PROVIDER | OTHER | 3810009610 | 01 | VA | WV MEDICAID | OTHER | 302939 | 01 | VA | ANTHEM | OTHER | 638329 | 01 | VA | SOUTHERN HEALTH | OTHER | 30680 | 01 | VA | OPTIMA | OTHER | 1033199708 | 05 | VA | MEDICAID |