MEDICARE: MR. KENNETH EUGENE HOFF MD

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	207Q00000X	Family Medicine Physician	01024912A	IN

Other Identifiers

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

General Provider Information

NPI Number	:	1427057389
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. KENNETH EUGENE HOFF MD

Provider Business Mailing Address
First Line	:	700 MAIN STREET
Second Line	:
City	:	ROCHESTER
State	:	IN
Zip	:	46975-1506
Country	:	US
Telephone Number	:	574-223-4337
Fax Number	:	574-223-4375

Provider Business Practice Location Address
First Line	:	1300 EAST 9TH ST.
Second Line	:
City	:	ROCHESTER
State	:	IN
Zip	:	46975-1506
Country	:	US
Telephone Number	:	574-223-2020
Fax Number	:	574-224-5847

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

Provider Enumeration Date	:	07/21/2005
Last Update Date	:	12/11/2013

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