MEDICARE: DR. JOHN WILSON HOFFMAN JR. DO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207L00000X	Anesthesiology Physician	OT012712	PA

General Provider Information

NPI Number	:	1982833042
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN WILSON HOFFMAN JR. DO

Provider Business Mailing Address
First Line	:	PO BOX 737
Second Line	:
City	:	EAST BUTLER
State	:	PA
Zip	:	16029-0737
Country	:	US
Telephone Number	:	724-256-9700
Fax Number	:	724-256-9705

Provider Business Practice Location Address
First Line	:	500 GRANT AVE
Second Line	:
City	:	EAST BUTLER
State	:	PA
Zip	:	16029-0737
Country	:	US
Telephone Number	:	724-256-9700
Fax Number	:	724-256-9705

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/10/2009
Last Update Date	:	01/06/2017

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