Basic Information
| Provider Information | |||||||||
| NPI: | 1215002068 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HOFSTETTER | ||||||||
| FirstName: | PHILIP | ||||||||
| MiddleName: | J | ||||||||
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| Credential: | AUDIOLOGIST | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 589 | ||||||||
| Address2: | |||||||||
| City: | PETERSBURG | ||||||||
| State: | AK | ||||||||
| PostalCode: | 998330589 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9077724291 | ||||||||
| FaxNumber: | 9077723085 | ||||||||
| Practice Location | |||||||||
| Address1: | 103 FRAM STREET | ||||||||
| Address2: | |||||||||
| City: | PETERSBURG | ||||||||
| State: | AK | ||||||||
| PostalCode: | 99833 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9077724291 | ||||||||
| FaxNumber: | 9077723085 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/21/2006 | ||||||||
| LastUpdateDate: | 02/06/2019 | ||||||||
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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 | 231H00000X | 63 | AK | Y | Speech, Language and Hearing Service Providers | Audiologist |
No ID Information.