Provider Demographics
NPI:1861523193
Name:HOCH, RANDALL J (OD)
Entity type:Individual
Prefix:
First Name:RANDALL
Middle Name:J
Last Name:HOCH
Suffix:
Gender:M
Credentials:OD
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 59
Mailing Address - Street 2:
Mailing Address - City:LEWISTOWN
Mailing Address - State:MT
Mailing Address - Zip Code:59457-0059
Mailing Address - Country:US
Mailing Address - Phone:406-535-2020
Mailing Address - Fax:406-535-3210
Practice Address - Street 1:119 E MAIN ST
Practice Address - Street 2:
Practice Address - City:LEWISTOWN
Practice Address - State:MT
Practice Address - Zip Code:59457-1710
Practice Address - Country:US
Practice Address - Phone:406-535-5488
Practice Address - Fax:406-535-3210
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-08
Last Update Date:2023-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT555152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0483650Medicaid
MTP00227881OtherRAIL ROAD MEDICARE
MT0483650Medicaid
MTP00227881OtherRAIL ROAD MEDICARE