Healthcare Provider Details

I. General information

NPI: 1821281932
Provider Name (Legal Business Name): HOFFMAN EYE CARE PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/22/2007
Last Update Date: 11/16/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

425 PATTERSON ROAD SUITE 405
GRAND JCT CO
81506-1910
US

IV. Provider business mailing address

425 PATTERSON RD SUITE 405
GRAND JCT CO
81506-1953
US

V. Phone/Fax

Practice location:
  • Phone: 970-256-0400
  • Fax:
Mailing address:
  • Phone: 970-256-0400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number41908
License Number StateCO

VIII. Authorized Official

Name: WALTER J HOFFMAN
Title or Position: PRESIDENT
Credential: MD
Phone: 970-256-0400