Provider Demographics
NPI:1811925712
Name:HOFFMAN, LEROY GEORGE (MD)
Entity type:Individual
Prefix:
First Name:LEROY
Middle Name:GEORGE
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 16098
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27516-6098
Mailing Address - Country:US
Mailing Address - Phone:919-967-6646
Mailing Address - Fax:919-967-6647
Practice Address - Street 1:805 6TH AVE W STE 100
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28739-4137
Practice Address - Country:US
Practice Address - Phone:828-692-8045
Practice Address - Fax:828-692-6630
Is Sole Proprietor?:No
Enumeration Date:2006-06-29
Last Update Date:2020-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC201452085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC42797OtherBLUE CROSS/BLUE SHIELD
NC7942797Medicaid
NCNCI268AOtherMEDICARE PTAN
NCC87493Medicare UPIN
NC212291Medicare PIN
NC7942797Medicaid