Healthcare Provider Details

I. General information

NPI: 1427022532
Provider Name (Legal Business Name): CHARLES WILLIAM HOF M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/15/2006
Last Update Date: 02/16/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3737 W. WALNUT P.O. 1353
ROGERS AR
72756-1353
US

IV. Provider business mailing address

3737 W. WALNUT P.O. 1353
ROGERS AR
72756-1353
US

V. Phone/Fax

Practice location:
  • Phone: 479-246-1700
  • Fax: 479-631-2629
Mailing address:
  • Phone: 479-246-1700
  • Fax: 479-631-2629

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberC-4723
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: