Provider Demographics
NPI:1083600399
Name:HOFFMAN, THOMAS S (DO)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:S
Last Name:HOFFMAN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 254376
Mailing Address - Street 2:
Mailing Address - City:PATRICK AIR FORCE BASE
Mailing Address - State:FL
Mailing Address - Zip Code:32925-4376
Mailing Address - Country:US
Mailing Address - Phone:321-258-2911
Mailing Address - Fax:
Practice Address - Street 1:1381 S PATRICK DR
Practice Address - Street 2:45 MEDICAL GROUP
Practice Address - City:PATRICK AIR FORCE BASE
Practice Address - State:FL
Practice Address - Zip Code:32925-3606
Practice Address - Country:US
Practice Address - Phone:321-494-5981
Practice Address - Fax:321-494-1378
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA20A69472083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAD000Medicare UPIN