Basic Information
| Provider Information | |||||||||
| NPI: | 1134181639 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HOEFER | ||||||||
| FirstName: | MARK | ||||||||
| MiddleName: | L | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3707 N 7TH ST | ||||||||
| Address2: | STE. 200 | ||||||||
| City: | PHOENIX | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 850145095 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6022649100 | ||||||||
| FaxNumber: | 6022656955 | ||||||||
| Practice Location | |||||||||
| Address1: | 1520 S DOBSON RD | ||||||||
| Address2: | STE 302 | ||||||||
| City: | MESA | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 852024725 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4804611088 | ||||||||
| FaxNumber: | 4804611657 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/03/2006 | ||||||||
| LastUpdateDate: | 04/08/2014 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RG0100X | 11108 | AZ | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Gastroenterology |
No ID Information.