Provider Demographics
NPI:1548271646
Name:HOIG, OLIVER ELLSWORTH (MD)
Entity type:Individual
Prefix:DR
First Name:OLIVER
Middle Name:ELLSWORTH
Last Name:HOIG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 15010
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37901-5010
Mailing Address - Country:US
Mailing Address - Phone:865-541-8485
Mailing Address - Fax:865-541-8727
Practice Address - Street 1:2018 CLINCH AVE
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37916-2301
Practice Address - Country:US
Practice Address - Phone:865-541-8485
Practice Address - Fax:865-541-8727
Is Sole Proprietor?:No
Enumeration Date:2006-08-11
Last Update Date:2022-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME155164207LP3000X
TN39612207LP3000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP3000XAllopathic & Osteopathic PhysiciansAnesthesiologyPediatric Anesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN100048702OtherTENNCARE PHP
KY64101496OtherKENTUCKY MEDICAID
TN4105413OtherTENNCARE SELECT
TN4105413OtherBLUE CROSS BLUE SHIELD
TN4105413OtherBLUECARE
TN5440547Medicaid