Provider Demographics
NPI:1851598510
Name:HOEFER, MATTHEW HENRY (DO)
Entity Type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:HENRY
Last Name:HOEFER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2076 STENNIS DR
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32506-2931
Mailing Address - Country:US
Mailing Address - Phone:706-993-5969
Mailing Address - Fax:
Practice Address - Street 1:NAVAL AEROSPACE MEDICAL INSTITUTE- CODE 33
Practice Address - Street 2:340 HULSE ROAD
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32508
Practice Address - Country:US
Practice Address - Phone:850-452-3691
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN02003151A2083A0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083A0100XAllopathic & Osteopathic PhysiciansPreventive MedicineAerospace Medicine