Eric Daniel Hosler, D.M.D.
Individual provider Active NPI Dentist · Columbia, IL
NPI 1225445554 · NPPES record last updated Jul 18, 2014
Key facts
- NPI
- 1225445554
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 019.029932 (IL)
- Practice address
- 120 Veterans Pkwy
Columbia, IL 62236-2508 - Phone
- (618) 281-7178
- NPI assigned
- Jul 18, 2014
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MO
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160526001055 | MO | Order and Referring Only - Oral Surgery |
6406146844 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 019.029932 | IL | MD | Dentist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 019.029932 | IL | Yes |
Addresses
Primary practice location
120 Veterans Pkwy
Columbia, IL 62236-2508
Mailing address
120 Veterans Pkwy
Columbia, IL 62236-2508
Phone (618) 281-7178
Other providers in Columbia, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 18, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.