Provider Demographics
NPI:1003239393
Name:HOFFMAN, DAVID
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:HOFFMAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 WASHINGTON AVE
Mailing Address - Street 2:STE B
Mailing Address - City:OCEAN SPRINGS
Mailing Address - State:MS
Mailing Address - Zip Code:39564-2859
Mailing Address - Country:US
Mailing Address - Phone:228-875-0595
Mailing Address - Fax:228-875-2210
Practice Address - Street 1:5935 WASHINGTON AVE
Practice Address - Street 2:SUITE B
Practice Address - City:OCEAN SPRINGS
Practice Address - State:MS
Practice Address - Zip Code:39564-2642
Practice Address - Country:US
Practice Address - Phone:228-875-0595
Practice Address - Fax:228-875-2210
Is Sole Proprietor?:No
Enumeration Date:2014-01-23
Last Update Date:2016-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS1220111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor