Healthcare Provider Details

I. General information

NPI: 1679753388
Provider Name (Legal Business Name): WILLIAM HOFFMAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/09/2007
Last Update Date: 11/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1120 15TH ST
AUGUSTA GA
30912-0004
US

IV. Provider business mailing address

1499 WALTON WAY STE 1400
AUGUSTA GA
30901-2602
US

V. Phone/Fax

Practice location:
  • Phone: 706-721-4158
  • Fax:
Mailing address:
  • Phone: 706-724-6100
  • Fax: 706-722-5187

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0205X
TaxonomyPediatric Endocrinology Physician
License Number026555
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: