Provider Demographics
NPI:1447424916
Name:HOFFMAN, JONATHAN DOUGLAS (PHARMD, MBA)
Entity Type:Individual
Prefix:MR
First Name:JONATHAN
Middle Name:DOUGLAS
Last Name:HOFFMAN
Suffix:
Gender:M
Credentials:PHARMD, MBA
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Mailing Address - Street 1:GEORGE E WAHLEN DEPARTMENT OF VETERANS CTR
Mailing Address - Street 2:500 FOOTHILL DRIVE
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84148-0001
Mailing Address - Country:US
Mailing Address - Phone:801-582-1565
Mailing Address - Fax:801-584-2576
Practice Address - Street 1:GEORGE E WAHLEN DEPARTMENT OF VETERANS CTR
Practice Address - Street 2:500 FOOTHILL DRIVE
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84148-0001
Practice Address - Country:US
Practice Address - Phone:801-582-1565
Practice Address - Fax:801-584-2576
Is Sole Proprietor?:No
Enumeration Date:2008-04-16
Last Update Date:2014-05-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
UT7000386-17011835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy