Healthcare Provider Details

I. General information

NPI: 1306488739
Provider Name (Legal Business Name): HOFTB ANESTHESIA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/17/2019
Last Update Date: 10/17/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6320 W UNION HILLS DR STE 1400B
GLENDALE AZ
85308-1061
US

IV. Provider business mailing address

8311 E VIA DE VENTURA APT 2060
SCOTTSDALE AZ
85258-6617
US

V. Phone/Fax

Practice location:
  • Phone: 623-688-5400
  • Fax:
Mailing address:
  • Phone: 602-350-9862
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State

VIII. Authorized Official

Name: DEONNA CARLSON
Title or Position: NURSE ANESTHETIST
Credential: CRNA
Phone: 602-450-9862