Healthcare Provider Details

I. General information

NPI: 1609895481
Provider Name (Legal Business Name): JAMES E HOFFMAN D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/19/2006
Last Update Date: 04/27/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3250 GORDONVILLE RD STE 301
CAPE GIRARDEAU MO
63703-5056
US

IV. Provider business mailing address

PO BOX 843225
KANSAS CITY MO
64184-3225
US

V. Phone/Fax

Practice location:
  • Phone: 573-334-9641
  • Fax:
Mailing address:
  • Phone: 708-633-1234
  • Fax: 708-342-7100

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberR7B50
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: