Healthcare Provider Details

I. General information

NPI: 1053307231
Provider Name (Legal Business Name): HOFIUS SURGICAL, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/23/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

217 N JEFFERSON ST SUITE B
NEW CASTLE PA
16101-2271
US

IV. Provider business mailing address

217 N JEFFERSON ST SUITE B
NEW CASTLE PA
16101-2271
US

V. Phone/Fax

Practice location:
  • Phone: 724-654-3010
  • Fax: 724-654-3037
Mailing address:
  • Phone: 724-654-3010
  • Fax: 724-654-3037

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberOS0008334L
License Number StatePA

VIII. Authorized Official

Name: DAVID RANDALL HOFIUS
Title or Position: PRESIDENT
Credential: D.O.
Phone: 724-654-3010