Healthcare Provider Details

I. General information

NPI: 1639512007
Provider Name (Legal Business Name): DEANN HOFER D.P.M.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/16/2013
Last Update Date: 12/01/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7505 VILLAGE SQUARE DR STE 101
CASTLE PINES CO
80108-3693
US

IV. Provider business mailing address

7505 VILLAGE SQUARE DR STE 101
CASTLE PINES CO
80108-3693
US

V. Phone/Fax

Practice location:
  • Phone: 303-805-5156
  • Fax: 303-805-5157
Mailing address:
  • Phone: 303-805-5156
  • Fax: 303-805-5157

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213ES0000X
TaxonomySports Medicine Podiatrist
License NumberPOD0000806
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberPOD0000806
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: