Provider Demographics
NPI:1033406657
Name:HOFFMAN, HOLLY LEE (MD)
Entity Type:Individual
Prefix:
First Name:HOLLY
Middle Name:LEE
Last Name:HOFFMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:2619 COLONIAL DR
Mailing Address - Street 2:SUITE A
Mailing Address - City:HELENA
Mailing Address - State:MT
Mailing Address - Zip Code:59601-4948
Mailing Address - Country:US
Mailing Address - Phone:406-442-1231
Mailing Address - Fax:406-442-6857
Practice Address - Street 1:2619 COLONIAL DR
Practice Address - Street 2:SUITE A
Practice Address - City:HELENA
Practice Address - State:MT
Practice Address - Zip Code:59601-4948
Practice Address - Country:US
Practice Address - Phone:406-442-1231
Practice Address - Fax:406-442-6857
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-03
Last Update Date:2015-11-25
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CO4049207Q00000X
MT34287207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
M011004906Medicare PIN