Basic Information
| Provider Information | |||||||||
| NPI: | 1871092189 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HOSKIN | ||||||||
| FirstName: | JOSEPH | ||||||||
| MiddleName: | WELLS | ||||||||
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| Credential: | PA-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3730 NE EAGLE CREEK CT | ||||||||
| Address2: | |||||||||
| City: | MOUNTAIN HOME | ||||||||
| State: | ID | ||||||||
| PostalCode: | 836476164 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4127152934 | ||||||||
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| Practice Location | |||||||||
| Address1: | 465 MCKENNA DR | ||||||||
| Address2: | |||||||||
| City: | MOUNTAIN HOME | ||||||||
| State: | ID | ||||||||
| PostalCode: | 836472143 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2085879703 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/02/2018 | ||||||||
| LastUpdateDate: | 02/02/2018 | ||||||||
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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 | 363AM0700X | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Medical |
No ID Information.