Provider Demographics
NPI:1659320919
Name:HOFFMAN, TAUNYA F (PA)
Entity Type:Individual
Prefix:
First Name:TAUNYA
Middle Name:F
Last Name:HOFFMAN
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120-B OSIGIAN BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:WARNER ROBINS
Mailing Address - State:GA
Mailing Address - Zip Code:31088-8939
Mailing Address - Country:US
Mailing Address - Phone:478-953-5358
Mailing Address - Fax:478-953-5340
Practice Address - Street 1:3051 WATSON BLVD
Practice Address - Street 2:SUITE 525
Practice Address - City:WARNER ROBINS
Practice Address - State:GA
Practice Address - Zip Code:31093-8536
Practice Address - Country:US
Practice Address - Phone:478-953-4563
Practice Address - Fax:478-953-4616
Is Sole Proprietor?:No
Enumeration Date:2006-05-06
Last Update Date:2013-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA004246363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA297722922AMedicaid
GA97WCFLHMedicare ID - Type Unspecified