Healthcare Provider Details

I. General information

NPI: 1578935201
Provider Name (Legal Business Name): PHILIP JOHN HOFSCHIRE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/21/2015
Last Update Date: 12/21/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13650 E MISSISSIPPI AVE SUITE 100
AURORA CO
80012-3561
US

IV. Provider business mailing address

750 W HAMPDEN AVE SUITE 105
ENGLEWOOD CO
80110-2165
US

V. Phone/Fax

Practice location:
  • Phone: 303-695-1338
  • Fax: 303-695-8814
Mailing address:
  • Phone: 303-341-4730
  • Fax: 303-341-4708

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberDR.0057473
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: