Provider Demographics
NPI:1477508638
Name:HOFFMAN, THOMAS W (CRNA)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:W
Last Name:HOFFMAN
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 55059
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35255-5059
Mailing Address - Country:US
Mailing Address - Phone:256-764-9697
Mailing Address - Fax:256-764-9699
Practice Address - Street 1:1400 MCFARLAND BLVD N
Practice Address - Street 2:
Practice Address - City:TUSCALOOSA
Practice Address - State:AL
Practice Address - Zip Code:35406-2209
Practice Address - Country:US
Practice Address - Phone:205-345-5500
Practice Address - Fax:205-502-5152
Is Sole Proprietor?:No
Enumeration Date:2006-05-24
Last Update Date:2013-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-022792367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALS05394Medicare UPIN
AL051552163Medicare ID - Type Unspecified