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NPI Code Detail

MEDICARE: PHILLIP HOFFARTH

MEDICARE: PHILLIP HOFFARTH
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
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1346188125
Entity Type Code : Individual
Provider Name (Legal Business Name) : PHILLIP HOFFARTH
Provider Business Mailing Address
First Line : 4820 23RD AVE S STE 200
Second Line :
City : FARGO
State : ND
Zip : 58104-9138
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4820 23RD AVE S STE 200
Second Line :
City : FARGO
State : ND
Zip : 58104-9138
Country : US
Telephone Number : 701-293-4113
Fax Number : 701-293-4113
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/23/2026
Last Update Date : 03/23/2026

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Directions to “ PHILLIP HOFFARTH ” Practice Location

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