Provider Demographics
NPI:1104868504
Name:HOFER, CAROLYN ANNETTE (MD)
Entity Type:Individual
Prefix:DR
First Name:CAROLYN
Middle Name:ANNETTE
Last Name:HOFER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41 N 170TH RD
Mailing Address - Street 2:
Mailing Address - City:SALINA
Mailing Address - State:KS
Mailing Address - Zip Code:67401-9265
Mailing Address - Country:US
Mailing Address - Phone:785-488-3733
Mailing Address - Fax:
Practice Address - Street 1:1410 E IRON AVE
Practice Address - Street 2:SUITE 1
Practice Address - City:SALINA
Practice Address - State:KS
Practice Address - Zip Code:67401-3284
Practice Address - Country:US
Practice Address - Phone:785-826-1580
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-23978207R00000X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Not Answered207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease