Healthcare Provider Details

I. General information

NPI: 1477508638
Provider Name (Legal Business Name): THOMAS W. HOFFMAN CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/24/2006
Last Update Date: 12/23/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 MCFARLAND BLVD N
TUSCALOOSA AL
35406-2209
US

IV. Provider business mailing address

PO BOX 55059
BIRMINGHAM AL
35255-5059
US

V. Phone/Fax

Practice location:
  • Phone: 205-345-5500
  • Fax: 205-502-5152
Mailing address:
  • Phone: 256-764-9697
  • Fax: 256-764-9699

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number1-022792
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: