MEDICARE: DR. JEFFREY SCOTT HOFER M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	21509	KY
2	207R00000X	Internal Medicine Physician	21509	KY

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	110000704	OTHER	KY	RAILROAD MEDICARE

General Provider Information

NPI Number	:	1215933726
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JEFFREY SCOTT HOFER M.D.

Provider Business Mailing Address
First Line	:	2816 VEACH RD
Second Line	:	SUITE 403
City	:	OWENSBORO
State	:	KY
Zip	:	42303-6295
Country	:	US
Telephone Number	:	270-684-1145
Fax Number	:	270-852-6566

Provider Business Practice Location Address
First Line	:	2816 VEACH RD
Second Line	:	SUITE 403
City	:	OWENSBORO
State	:	KY
Zip	:	42303-6295
Country	:	US
Telephone Number	:	270-684-1145
Fax Number	:	270-852-6566

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/21/2005
Last Update Date	:	06/22/2015

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