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NPI Code Detail

MEDICARE: TODD K HOFACKER CRNA

MEDICARE: TODD K HOFACKER CRNA
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
1367500000XCertified Registered Nurse AnesthetistRN167984OH

Other Identifiers

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

General Provider Information

NPI Number : 1609868587
Entity Type Code : Individual
Provider Name (Legal Business Name) : TODD K HOFACKER CRNA
Provider Business Mailing Address
First Line : PO BOX 280
Second Line :
City : WESTERVILLE
State : OH
Zip : 43086-0280
Country : US
Telephone Number : 614-523-2266
Fax Number : 614-523-2288
Provider Business Practice Location Address
First Line : 1430 COLUMBUS AVE
Second Line :
City : WASHINGTON COURT HOUSE
State : OH
Zip : 43160-1703
Country : US
Telephone Number : 614-523-2266
Fax Number : 614-523-2288
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/17/2005
Last Update Date : 07/09/2007

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Directions to “ TODD K HOFACKER CRNA” Practice Location

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