Provider Demographics
NPI:1639498777
Name:HOFF, BRADLEY (PA-C)
Entity Type:Individual
Prefix:
First Name:BRADLEY
Middle Name:
Last Name:HOFF
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:820 5TH ST N
Mailing Address - Street 2:PO BOX 79
Mailing Address - City:CARRINGTON
Mailing Address - State:ND
Mailing Address - Zip Code:58421-1223
Mailing Address - Country:US
Mailing Address - Phone:701-652-2515
Mailing Address - Fax:701-652-2846
Practice Address - Street 1:820 5TH ST N
Practice Address - Street 2:
Practice Address - City:CARRINGTON
Practice Address - State:ND
Practice Address - Zip Code:58421
Practice Address - Country:US
Practice Address - Phone:701-652-2515
Practice Address - Fax:701-652-2846
Is Sole Proprietor?:No
Enumeration Date:2010-05-28
Last Update Date:2018-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND363AM0700X
NDPAC0423363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical