Healthcare Provider Details

I. General information

NPI: 1295892438
Provider Name (Legal Business Name): WILLIAM ROBERT HOFFMAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/03/2007
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11630 COMMONWEALTH DR SUITE 300,400
LOUISVILLE KY
40299-2300
US

IV. Provider business mailing address

PO BOX 950248
LOUISVILLE KY
40295-0248
US

V. Phone/Fax

Practice location:
  • Phone: 502-267-6292
  • Fax: 502-267-7104
Mailing address:
  • Phone: 502-489-5730
  • Fax: 502-489-5733

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number29663
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code2083X0100X
TaxonomyOccupational Medicine Physician
License Number29663
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: