Provider Demographics
NPI:1861511362
Name:HOSFORD, JOHN L
Entity type:Individual
Prefix:MR
First Name:JOHN
Middle Name:L
Last Name:HOSFORD
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:HEARALL
Other - Middle Name:
Other - Last Name:CORPORATION
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:4836 REAN MEADOW DR
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45440-2031
Mailing Address - Country:US
Mailing Address - Phone:937-299-3000
Mailing Address - Fax:
Practice Address - Street 1:4836 REAN MEADOW DR
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45440-2031
Practice Address - Country:US
Practice Address - Phone:937-299-3000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-28
Last Update Date:2014-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH01515237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
000000000825OtherHEARING AID SUPPLIER
OH22000000272850OtherPROVIDER # ANTHEM BLUE CR