Provider Demographics
NPI:1942648225
Name:HOFFMAN, PHILIP JOHN (DO)
Entity Type:Individual
Prefix:
First Name:PHILIP
Middle Name:JOHN
Last Name:HOFFMAN
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 1:851 E 5TH ST STE 208
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:MO
Mailing Address - Zip Code:63090-3129
Mailing Address - Country:US
Mailing Address - Phone:636-239-8097
Mailing Address - Fax:
Practice Address - Street 1:851 E 5TH ST STE 208
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:MO
Practice Address - Zip Code:63090-3129
Practice Address - Country:US
Practice Address - Phone:636-239-8097
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-10
Last Update Date:2023-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2019045767207RS0010X
GA78396207RS0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RS0010XAllopathic & Osteopathic PhysiciansInternal MedicineSports Medicine