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NPI Code Detail

MEDICARE: DR. GREGORY R HOFFMAN M.D.

MEDICARE:  DR. GREGORY R HOFFMAN  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
1207Q00000XFamily Medicine PhysicianMD22890OR
2207Q00000XFamily Medicine Physician7266855-1205UT

General Provider Information

NPI Number : 1649275439
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. GREGORY R HOFFMAN M.D.
Provider Business Mailing Address
First Line : PO BOX 27128
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84127-0128
Country : US
Telephone Number : 801-571-0030
Fax Number :
Provider Business Practice Location Address
First Line : 955 E 11400 S
Second Line :
City : SANDY
State : UT
Zip : 84094-6946
Country : US
Telephone Number : 801-571-0030
Fax Number : 801-553-3196
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/17/2005
Last Update Date : 05/20/2016

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Directions to “ DR. GREGORY R HOFFMAN M.D.” Practice Location

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