Provider Demographics
NPI:1073117867
Name:HOFFMANN, PAUL JOSEPH (RPH)
Entity Type:Individual
Prefix:PROF
First Name:PAUL
Middle Name:JOSEPH
Last Name:HOFFMANN
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1106 CRESTVIEW DR
Mailing Address - Street 2:
Mailing Address - City:PORT WASHINGTON
Mailing Address - State:WI
Mailing Address - Zip Code:53074-1347
Mailing Address - Country:US
Mailing Address - Phone:414-614-4123
Mailing Address - Fax:414-892-5783
Practice Address - Street 1:1821 N 16TH ST
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53205-1626
Practice Address - Country:US
Practice Address - Phone:414-977-0001
Practice Address - Fax:414-892-5783
Is Sole Proprietor?:No
Enumeration Date:2020-11-23
Last Update Date:2020-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI106351835P2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P2201XPharmacy Service ProvidersPharmacistAmbulatory Care