Provider Demographics
NPI:1457335689
Name:HOFFMAN, JOHN A (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:A
Last Name:HOFFMAN
Suffix:
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:PO BOX 607
Mailing Address - Street 2:
Mailing Address - City:APPOMATTOX
Mailing Address - State:VA
Mailing Address - Zip Code:24522-0607
Mailing Address - Country:US
Mailing Address - Phone:434-352-8235
Mailing Address - Fax:434-352-5532
Practice Address - Street 1:131 JONES ST
Practice Address - Street 2:
Practice Address - City:APPOMATTOX
Practice Address - State:VA
Practice Address - Zip Code:24522-9830
Practice Address - Country:US
Practice Address - Phone:434-332-7367
Practice Address - Fax:434-332-1757
Is Sole Proprietor?:No
Enumeration Date:2005-12-01
Last Update Date:2013-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101041287207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA005608830Medicaid
0907130002OtherDME APPOMATTOX
248720OtherANTHEM
080171330OtherMEDICARE RAILROAD PROVIDER NUMBER
VA1457335689Medicaid
VA1457335689Medicaid
VA014920C58Medicare PIN