Provider Demographics
NPI:1629318191
Name:DUVALL, ALEXANDRA HOFFMAN (PA-C)
Entity Type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:HOFFMAN
Last Name:DUVALL
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:ALEXANDRA
Other - Middle Name:ELIZABETH
Other - Last Name:HOFFMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:103 CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:HIAWASSEE
Mailing Address - State:GA
Mailing Address - Zip Code:30546-3223
Mailing Address - Country:US
Mailing Address - Phone:706-896-4673
Mailing Address - Fax:
Practice Address - Street 1:103 CHURCH ST
Practice Address - Street 2:
Practice Address - City:HIAWASSEE
Practice Address - State:GA
Practice Address - Zip Code:30546-3223
Practice Address - Country:US
Practice Address - Phone:706-896-4673
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-02-21
Last Update Date:2016-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA6711363A00000X
NC0010-04601363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant