Provider Demographics
NPI:1700189206
Name:J M HOFFMAN PC
Entity Type:Organization
Organization Name:J M HOFFMAN PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOY
Authorized Official - Middle Name:MARY
Authorized Official - Last Name:DUNWOODIE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:269-208-2649
Mailing Address - Street 1:16765 QUAYSIDE DR
Mailing Address - Street 2:
Mailing Address - City:MILTON
Mailing Address - State:GA
Mailing Address - Zip Code:30004-8107
Mailing Address - Country:US
Mailing Address - Phone:269-208-2649
Mailing Address - Fax:
Practice Address - Street 1:16765 QUAYSIDE DR
Practice Address - Street 2:
Practice Address - City:MILTON
Practice Address - State:GA
Practice Address - Zip Code:30004-8107
Practice Address - Country:US
Practice Address - Phone:269-208-2649
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-06
Last Update Date:2014-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR009226261Q00000X
MI2301006871261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/CenterGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIT97168 MRMedicare UPIN
MIMI 3542Medicare PIN