Healthcare Provider Details

I. General information

NPI: 1346343704
Provider Name (Legal Business Name): JEFFREY G HOFFMAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/07/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 GLENLAKE PARKWAY DEPARTMENT OF ENT OTOLARYNGOLOGY
ATLANTA GA
30328
US

IV. Provider business mailing address

3495 PIEDMONT ROAD NE NINE PIEDMONT CENTER
ATLANTA GA
30305
US

V. Phone/Fax

Practice location:
  • Phone: 770-677-6137
  • Fax: 770-677-7332
Mailing address:
  • Phone: 404-364-7000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number033355
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: