1598793325 NPI number — JEFFREY S HOFFA D.O.

Table of content: JEFFREY S HOFFA D.O. (NPI 1598793325)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1598793325 NPI number — JEFFREY S HOFFA D.O.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HOFFA
Provider First Name:
JEFFREY
Provider Middle Name:
S
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
D.O.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1598793325
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/26/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
501 LAPEER
Provider Second Line Business Mailing Address:
HEALTH DELIVERY INC.
Provider Business Mailing Address City Name:
SAGINAW
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48607
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
989-759-6400
Provider Business Mailing Address Fax Number:
989-759-6423

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1490 NORTH M-52
Provider Second Line Business Practice Location Address:
HEALTH DELIVERY INC.
Provider Business Practice Location Address City Name:
OWOSSO
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48867
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
989-729-4848
Provider Business Practice Location Address Fax Number:
989-729-4849
Provider Enumeration Date:
06/29/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  5101012282 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 080G310660 . This is a "BLUE CROSS BLUE SHIELD OF MICHIGAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1598793325 . This is a "MOLINA HEALTH CARE OF MICHIGAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0G36111098 . This is a "MEDICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 34401 . This is a "HEALTHPLAN OF MICHIGAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0980571 . This is a "HEALTH PLUS OF MICHIGAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1598793325 , issued by the state of ( MI ) . This identifiers is of the category "MEDICAID".
  • Identifier: 168111 . This is a "GREAT LAKES HEALTH PLAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 381908328 . This is a "PPOM/COFINITY" identifier . This identifiers is of the category "OTHER".
  • Identifier: 381908328 . This is a "PRIORITY HEALTH" identifier . This identifiers is of the category "OTHER".
  • Identifier: G32625 . This is a "HAP OF MICHIGAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 381908328-414 . This is a "CARESOURCE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 4343639 , issued by the state of ( MI ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1032272 . This is a "MCLAREN HEALTH PLAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 080G310660 . This is a "BLUE CARE NETWORK" identifier . This identifiers is of the category "OTHER".
  • Identifier: 381908328 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com