Provider Demographics
NPI:1053618918
Name:DONALD G HOVANCSEK, D.P.M. PS
Entity type:Organization
Organization Name:DONALD G HOVANCSEK, D.P.M. PS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PODIATRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:G
Authorized Official - Last Name:HOVANCSEK
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:360-943-9600
Mailing Address - Street 1:2828 MARTIN WAY E
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98506-4946
Mailing Address - Country:US
Mailing Address - Phone:360-943-9600
Mailing Address - Fax:360-943-9694
Practice Address - Street 1:2828 MARTIN WAY E
Practice Address - Street 2:
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98506-4946
Practice Address - Country:US
Practice Address - Phone:360-943-9600
Practice Address - Fax:360-943-9694
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-11
Last Update Date:2012-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPO00000155213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot SurgeryGroup - Single Specialty