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NPI Code Detail

MEDICARE: KELLY ANN HOOFMAN MD

MEDICARE: KELLY ANN HOOFMAN 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
1207R00000XInternal Medicine Physician2023023835MO
2208M00000XHospitalist Physician2023023835MO

General Provider Information

NPI Number : 1508568155
Entity Type Code : Individual
Provider Name (Legal Business Name) : KELLY ANN HOOFMAN MD
Provider Business Mailing Address
First Line : 1008 S SPRING AVE
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63110-2520
Country : US
Telephone Number : 314-977-2605
Fax Number : 314-977-1664
Provider Business Practice Location Address
First Line : 1201 S GRAND BLVD
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63104-1016
Country : US
Telephone Number : 314-257-8000
Fax Number : 314-977-1664
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/20/2023
Last Update Date : 04/15/2026

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Directions to “ KELLY ANN HOOFMAN MD” Practice Location

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