Healthcare Provider Details

I. General information

NPI: 1821638412
Provider Name (Legal Business Name): LAURA MARGARET HOFBAUER PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/10/2020
Last Update Date: 01/09/2026
Certification Date: 01/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7001 ROGERS AVE FL 6
FORT SMITH AR
72903-4073
US

IV. Provider business mailing address

PO BOX 776084
CHICAGO IL
60677-6084
US

V. Phone/Fax

Practice location:
  • Phone: 479-274-5100
  • Fax: 479-274-5179
Mailing address:
  • Phone: 479-274-5100
  • Fax: 479-274-5179

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number
License Number StateNULL
# 3
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberPA-1457
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: