Healthcare Provider Details
I. General information
NPI: 1013066604
Provider Name (Legal Business Name): EUGENE J HOFFMAN III MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 01/10/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4224 HOUMA BLVD SUITE 140
METAIRIE LA
70006-2933
US
IV. Provider business mailing address
4928 CRAIG AVE
METAIRIE LA
70003-7611
US
V. Phone/Fax
- Phone: 504-454-7721
- Fax: 504-454-5004
- Phone: 504-455-2438
- Fax: 504-454-5001
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207V00000X |
| Taxonomy | Obstetrics & Gynecology Physician |
| License Number | 012722 |
| License Number State | LA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: