Healthcare Provider Details

I. General information

NPI: 1437447620
Provider Name (Legal Business Name): SCOTT M HOFFMAN D.P.M.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/21/2011
Last Update Date: 09/19/2022
Certification Date: 09/19/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8607 E US HIGHWAY 36
AVON IN
46123-7960
US

IV. Provider business mailing address

8607 E US HIGHWAY 36 STE 100
AVON IN
46123-7960
US

V. Phone/Fax

Practice location:
  • Phone: 317-580-6372
  • Fax: 317-575-6909
Mailing address:
  • Phone: 317-745-5403
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number07001172A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: