Healthcare Provider Details

I. General information

NPI: 1740455302
Provider Name (Legal Business Name): LARRY WAYNE HOFF PA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/24/2008
Last Update Date: 05/28/2025
Certification Date: 05/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

624 JONES ST
APPOMATTOX VA
24522-4031
US

IV. Provider business mailing address

4038 THOMAS NELSON HWY
ARRINGTON VA
22922-2302
US

V. Phone/Fax

Practice location:
  • Phone: 434-263-4000
  • Fax: 434-263-4160
Mailing address:
  • Phone: 434-263-4000
  • Fax: 434-263-4160

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number0110009789
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA0000001218
License Number StateTN
# 3
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPAC0824
License Number StateND

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: