Healthcare Provider Details

I. General information

NPI: 1033476247
Provider Name (Legal Business Name): MEGAN HOFMEISTER M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/12/2012
Last Update Date: 07/07/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

UNIVERSITY OF KENTUCKY 800 ROSE STREET
LEXINGTON KY
40536-0001
US

IV. Provider business mailing address

111 WASHINGTON AVE SUITE 220
LEXINGTON KY
40536-0001
US

V. Phone/Fax

Practice location:
  • Phone: 859-218-2100
  • Fax:
Mailing address:
  • Phone: 859-218-2100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083P0901X
TaxonomyPublic Health & General Preventive Medicine Physician
License NumberR3223
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: