Provider Demographics
NPI:1033153812
Name:STOFFEY, ROBERT D (DO)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:D
Last Name:STOFFEY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8575 E PRINCESS DR STE 117
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85255-5437
Mailing Address - Country:US
Mailing Address - Phone:507-460-0026
Mailing Address - Fax:507-434-1477
Practice Address - Street 1:1000 1ST DR NW
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:MN
Practice Address - Zip Code:55912-2941
Practice Address - Country:US
Practice Address - Phone:507-434-1092
Practice Address - Fax:507-434-1477
Is Sole Proprietor?:No
Enumeration Date:2006-06-15
Last Update Date:2021-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20060029242085R0202X
AZ006040208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
P00313988OtherRAILROAD MEDICARE
MSPENDINGMedicaid
431560263074OtherTRICARE
MSPENDINGMedicaid
431560263074OtherTRICARE
MO956933230Medicare PIN