Provider Demographics
NPI:1902878127
Name:HOCHHALTER, ROBERT CRAIG (OD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:CRAIG
Last Name:HOCHHALTER
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 56
Mailing Address - Street 2:6303 OSGOOD AVE N
Mailing Address - City:STILLWATER
Mailing Address - State:MN
Mailing Address - Zip Code:55082-0056
Mailing Address - Country:US
Mailing Address - Phone:651-439-4265
Mailing Address - Fax:651-439-8602
Practice Address - Street 1:6303 OSGOOD AVE N
Practice Address - Street 2:
Practice Address - City:STILLWATER
Practice Address - State:MN
Practice Address - Zip Code:55082-6101
Practice Address - Country:US
Practice Address - Phone:651-439-4265
Practice Address - Fax:651-439-8602
Is Sole Proprietor?:No
Enumeration Date:2006-02-02
Last Update Date:2009-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2088152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNU27915Medicare UPIN