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NPI Code Detail

MEDICARE: DR. TIMOTHY D HOFFMANN M.D.

MEDICARE: DR. TIMOTHY D HOFFMANN 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
1207Q00000XFamily Medicine Physician4301066594MI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1295797942
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. TIMOTHY D HOFFMANN M.D.
Provider Business Mailing Address
First Line : 1140 N STATE ST
Second Line : SUITE 2805
City : SAINT IGNACE
State : MI
Zip : 49781-1048
Country : US
Telephone Number : 906-643-8689
Fax Number : 906-643-6716
Provider Business Practice Location Address
First Line : 1140 N STATE ST
Second Line : SUITE 2805
City : SAINT IGNACE
State : MI
Zip : 49781-1048
Country : US
Telephone Number : 906-643-8689
Fax Number : 906-643-6716
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/06/2006
Last Update Date : 09/03/2014

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