Provider Demographics
NPI:1184128795
Name:HOFSTEDE, JASON JAMES (DO)
Entity type:Individual
Prefix:DR
First Name:JASON
Middle Name:JAMES
Last Name:HOFSTEDE
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:527 TUSKEGEE AMN BLVD
Mailing Address - Street 2:BLDG 500
Mailing Address - City:SHEPPARD AFB
Mailing Address - State:TX
Mailing Address - Zip Code:76311-3430
Mailing Address - Country:US
Mailing Address - Phone:940-676-1227
Mailing Address - Fax:
Practice Address - Street 1:149 HART ST BLDG 1200
Practice Address - Street 2:
Practice Address - City:SHEPPARD AFB
Practice Address - State:TX
Practice Address - Zip Code:76311-3430
Practice Address - Country:US
Practice Address - Phone:940-676-3934
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-19
Last Update Date:2023-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN02005924A207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine