Provider Demographics
NPI:1568899839
Name:HOOFNAGLE, JAY H (MD)
Entity Type:Individual
Prefix:DR
First Name:JAY
Middle Name:H
Last Name:HOOFNAGLE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6707 DEMOCRACY BLVD
Mailing Address - Street 2:ROOM 644
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20892-5450
Mailing Address - Country:US
Mailing Address - Phone:301-496-1333
Mailing Address - Fax:301-480-8300
Practice Address - Street 1:1 CENTER DR
Practice Address - Street 2:OP-9, ACRF
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20892-0001
Practice Address - Country:US
Practice Address - Phone:301-496-6000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-02
Last Update Date:2013-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0019852207RI0008X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0008XAllopathic & Osteopathic PhysiciansInternal MedicineHepatology