Individual
DR. RICHARD B HOSTETTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
207 N TOWNLINE RD STE 101, LAGRANGE, IN 46761-1325
(260) 463-9316
(260) 463-9334
Mailing address
3702 NEW VISION DR BLDG B, FORT WAYNE, IN 46845-1703
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
01050312
IN
208600000X
Surgery Physician
Primary
01050312A
IN
2086X0206X
Surgical Oncology Physician
01050312A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200218420
—
IN
Enumeration date
01/23/2006
Last updated
03/15/2023
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