Healthcare Provider Details

I. General information

NPI: 1386624062
Provider Name (Legal Business Name): THOMAS LEE HOFFMAN D.P.M.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/19/2006
Last Update Date: 06/04/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

320 PARK AVE
CLEARFIELD PA
16830-2112
US

IV. Provider business mailing address

320 PARK AVE
CLEARFIELD PA
16830-2112
US

V. Phone/Fax

Practice location:
  • Phone: 814-765-3138
  • Fax: 814-765-3410
Mailing address:
  • Phone: 814-765-3138
  • Fax: 814-765-3410

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberSC-003105-L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: