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1548244718

NPI Code Detail

MEDICARE: DR. BRIAN ARTHUR HOFFMANN M.D.

MEDICARE: DR. BRIAN ARTHUR 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
1	208600000X	Surgery Physician	0101265993	VA
2	208600000X	Surgery Physician	048241	GA
3	208600000X	Surgery Physician	MD60061899	WA
4	208C00000X	Colon & Rectal Surgery Physician	0101265993	VA
5	208600000X	Surgery Physician	M10571	ID

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
6	P00717410	OTHER	ID	RR MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1548244718	OTHER	ID	REGENCE BLUESHIELD
2	77796	OTHER	ID	BC/ID
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	0244969	OTHER	WA	LABOR & INDUSTRIES

General Provider Information

NPI Number	:	1548244718
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BRIAN ARTHUR HOFFMANN M.D.

Provider Business Mailing Address
First Line	:	2315 8TH ST
Second Line	:
City	:	LEWISTON
State	:	ID
Zip	:	83501-7301
Country	:	US
Telephone Number	:	208-746-1383
Fax Number	:	208-746-6348

Provider Business Practice Location Address
First Line	:	2315 8TH ST
Second Line	:
City	:	LEWISTON
State	:	ID
Zip	:	83501-7301
Country	:	US
Telephone Number	:	208-746-1383
Fax Number	:	208-746-6348

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

Provider Enumeration Date	:	12/01/2005
Last Update Date	:	12/09/2020

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Directions to “ DR. BRIAN ARTHUR HOFFMANN M.D.” Practice Location

Language	Start Address	Practice Location

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