Basic Information
| Provider Information | |||||||||
| NPI: | 1396810057 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | HOFFMAN, MD, ASSOCIATED PATHOLOGISTS CHARTERED | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | AMERIPATH NEVADA | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4230 BURNHAM AVE | ||||||||
| Address2: | |||||||||
| City: | LAS VEGAS | ||||||||
| State: | NV | ||||||||
| PostalCode: | 891195408 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7027337866 | ||||||||
| FaxNumber: | 7027921319 | ||||||||
| Practice Location | |||||||||
| Address1: | 4230 BURNHAM AVE | ||||||||
| Address2: | |||||||||
| City: | LAS VEGAS | ||||||||
| State: | NV | ||||||||
| PostalCode: | 891195408 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7027337866 | ||||||||
| FaxNumber: | 7027921319 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/21/2006 | ||||||||
| LastUpdateDate: | 10/11/2018 | ||||||||
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| AuthorizedOfficialLastName: | WHEELER | ||||||||
| AuthorizedOfficialFirstName: | DARREN | ||||||||
| AuthorizedOfficialMiddleName: | THOMAS | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 7027337866 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207ZP0102X | 2744EXL4 | NV | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Pathology | Anatomic Pathology & Clinical Pathology |
No ID Information.