Healthcare Provider Details

I. General information

NPI: 1235382854
Provider Name (Legal Business Name): JOSEPH E. HOFFERT C.P.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/28/2008
Last Update Date: 09/18/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

345 HEALTHWEST DR
DOTHAN AL
36303-2053
US

IV. Provider business mailing address

PO BOX 729
DOTHAN AL
36302-0729
US

V. Phone/Fax

Practice location:
  • Phone: 334-836-4523
  • Fax: 334-836-2243
Mailing address:
  • Phone: 334-836-4523
  • Fax: 334-836-2243

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code222Z00000X
TaxonomyOrthotist
License Number168
License Number StateAL
# 2
Primary TaxonomyY
Taxonomy Code224P00000X
TaxonomyProsthetist
License Number168
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: