Healthcare Provider Details

I. General information

NPI: 1801971106
Provider Name (Legal Business Name): KATHLEEN TRAD HOFF PA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/26/2006
Last Update Date: 11/04/2025
Certification Date: 11/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 TULLIE RD NE FL PROGRAM7
ATLANTA GA
30329-2309
US

IV. Provider business mailing address

8346 BERKLEY RDG
ATLANTA GA
30350-3403
US

V. Phone/Fax

Practice location:
  • Phone: 44-785-8787
  • Fax:
Mailing address:
  • Phone: 202-543-5357
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number6292
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code2086S0120X
TaxonomyPediatric Surgery Physician
License NumberPA30249
License Number StateDC
# 3
Primary TaxonomyN
Taxonomy Code2086S0120X
TaxonomyPediatric Surgery Physician
License Number003116
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: