Healthcare Provider Details

I. General information

NPI: 1104868504
Provider Name (Legal Business Name): CAROLYN ANNETTE HOFER M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/11/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1410 E IRON AVE SUITE 1
SALINA KS
67401-3284
US

IV. Provider business mailing address

41 N 170TH RD
SALINA KS
67401-9265
US

V. Phone/Fax

Practice location:
  • Phone: 785-826-1580
  • Fax:
Mailing address:
  • Phone: 785-488-3733
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number04-23978
License Number StateKS
# 2
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number04-23978
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: