Healthcare Provider Details

I. General information

NPI: 1386838399
Provider Name (Legal Business Name): STEPHANIE M HOFF M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/03/2007
Last Update Date: 03/15/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

915 13TH AVE N
CLINTON IA
52732-5067
US

IV. Provider business mailing address

915 13TH AVE N
CLINTON IA
52732-5067
US

V. Phone/Fax

Practice location:
  • Phone: 563-243-2511
  • Fax: 563-243-0817
Mailing address:
  • Phone: 563-243-2511
  • Fax: 563-243-0817

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number38997
License Number StateIA
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number036-125497
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: