Basic Information
| Provider Information | |||||||||
| NPI: | 1912931676 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HOTH | ||||||||
| FirstName: | PETER | ||||||||
| MiddleName: | L | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 200 HAWKINS DR | ||||||||
| Address2: | FAMILY MEDICINE | ||||||||
| City: | IOWA CITY | ||||||||
| State: | IA | ||||||||
| PostalCode: | 522421009 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3193847000 | ||||||||
| FaxNumber: | 3194672814 | ||||||||
| Practice Location | |||||||||
| Address1: | 920 E 2ND AVE STE 201 | ||||||||
| Address2: | |||||||||
| City: | CORALVILLE | ||||||||
| State: | IA | ||||||||
| PostalCode: | 522412225 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3193847000 | ||||||||
| FaxNumber: | 3194672814 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/10/2006 | ||||||||
| LastUpdateDate: | 04/11/2018 | ||||||||
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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 | 207Q00000X | 228934 | MA | N | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | 45959 | CO | N | Allopathic & Osteopathic Physicians | Family Medicine | 207QS0010X | 45959 | CO | N | Allopathic & Osteopathic Physicians | Family Medicine | Sports Medicine | 207QS0010X | 40778 | IA | N | Allopathic & Osteopathic Physicians | Family Medicine | Sports Medicine | 207Q00000X | 40778 | IA | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 020544 | 01 | CO | KAISER COMMERCIAL NUMBER | OTHER | 34122753 | 05 | CO | MEDICAID |