Provider Demographics
NPI:1013066604
Name:HOFFMAN, EUGENE J III (MD)
Entity Type:Individual
Prefix:
First Name:EUGENE
Middle Name:J
Last Name:HOFFMAN
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4928 CRAIG AVE
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70003-7611
Mailing Address - Country:US
Mailing Address - Phone:504-455-2438
Mailing Address - Fax:504-454-5001
Practice Address - Street 1:4224 HOUMA BLVD
Practice Address - Street 2:SUITE 140
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70006-2933
Practice Address - Country:US
Practice Address - Phone:504-454-7721
Practice Address - Fax:504-454-5004
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA012722207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1158330Medicaid
LA1158330Medicaid
LA52218Medicare ID - Type Unspecified