Provider Demographics
NPI:1134241540
Name:DR KYLE D ABSHIRE & DR JAMES R HOFFMAN PA
Entity type:Organization
Organization Name:DR KYLE D ABSHIRE & DR JAMES R HOFFMAN PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:HOFFMAN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:904-264-1206
Mailing Address - Street 1:905 PARK AVE
Mailing Address - Street 2:100
Mailing Address - City:ORANGE PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32073-4101
Mailing Address - Country:US
Mailing Address - Phone:904-264-1206
Mailing Address - Fax:904-264-3685
Practice Address - Street 1:905 PARK AVE
Practice Address - Street 2:100
Practice Address - City:ORANGE PARK
Practice Address - State:FL
Practice Address - Zip Code:32073-4101
Practice Address - Country:US
Practice Address - Phone:904-264-1206
Practice Address - Fax:904-264-3685
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-04
Last Update Date:2012-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact ManagementGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL45637OtherBCBS
FL0853060001Medicare NSC
FL0853030001Medicare NSC
FL45637OtherBCBS
FLK0689Medicare PIN