Provider Demographics
NPI:1588651749
Name:HOFMANN, KURT (DO)
Entity Type:Individual
Prefix:DR
First Name:KURT
Middle Name:
Last Name:HOFMANN
Suffix:
Gender:M
Credentials:DO
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 1595
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:KY
Mailing Address - Zip Code:41105-1595
Mailing Address - Country:US
Mailing Address - Phone:606-408-6200
Mailing Address - Fax:606-408-6612
Practice Address - Street 1:912 PARK AVE
Practice Address - Street 2:
Practice Address - City:IRONTON
Practice Address - State:OH
Practice Address - Zip Code:45638-1596
Practice Address - Country:US
Practice Address - Phone:740-534-0021
Practice Address - Fax:740-534-0029
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-04
Last Update Date:2015-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34-005262207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000039632OtherANTHEM INSURANCE
KY64932601Medicaid
OH082230Medicaid
WV3810003386Medicaid
KY64932601Medicaid
1527101Medicare PIN
OH082230Medicaid
OHH403310Medicare PIN