Basic Information
| Provider Information | |||||||||
| NPI: | 1689632903 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HOFFER | ||||||||
| FirstName: | MICHAEL | ||||||||
| MiddleName: | JASON | ||||||||
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| Credential: | DO | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 760 | ||||||||
| Address2: | EMERGENCY MEDICINE ASSOCIATES PC | ||||||||
| City: | KITTANNING | ||||||||
| State: | PA | ||||||||
| PostalCode: | 16201 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8007772455 | ||||||||
| FaxNumber: | 6106176280 | ||||||||
| Practice Location | |||||||||
| Address1: | ONE NOLTE DRIVE | ||||||||
| Address2: | ARMSTRONG COUNTY MEMORIAL HOSPITAL | ||||||||
| City: | KITTANNING | ||||||||
| State: | PA | ||||||||
| PostalCode: | 16201 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7245438109 | ||||||||
| FaxNumber: | 7245438809 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/03/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | X | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | OS010588L | PA | Y | Allopathic & Osteopathic Physicians | Emergency Medicine |
ID Information
| ID | Type | State | Issuer | Description | 1472131 | 01 | PA | HIGHMARK BJ | OTHER |