Provider Demographics
NPI:1639178486
Name:HOFFMAN, JOEL A (MD)
Entity Type:Individual
Prefix:
First Name:JOEL
Middle Name:A
Last Name:HOFFMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:4150 DEPUTY BILL CANTRELL MEM ROAD
Mailing Address - Street 2:SUITE 260
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30040
Mailing Address - Country:US
Mailing Address - Phone:770-292-3045
Mailing Address - Fax:770-292-3046
Practice Address - Street 1:4150 DEPUTY BILL CANTRELL MEM ROAD
Practice Address - Street 2:SUITE 260
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30040
Practice Address - Country:US
Practice Address - Phone:470-297-0289
Practice Address - Fax:770-292-3046
Is Sole Proprietor?:No
Enumeration Date:2005-07-14
Last Update Date:2021-05-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA037833174400000X, 207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000580104FMedicaid
GA10034913Medicaid
GA3416408OtherAETNA
GA00580104FMedicaid
GA297069Medicaid
GA000580104NMedicaid
GAF26148Medicare UPIN
GA297069Medicaid
GA10034913Medicaid