Provider Demographics
NPI:1194720946
Name:SHOFFER, JAMES WILLIAM (DPM)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:WILLIAM
Last Name:SHOFFER
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:7200 W BELL RD
Mailing Address - Street 2:E101
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85308-8529
Mailing Address - Country:US
Mailing Address - Phone:623-825-9309
Mailing Address - Fax:623-505-9822
Practice Address - Street 1:7200 W BELL RD
Practice Address - Street 2:E101
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85308-8529
Practice Address - Country:US
Practice Address - Phone:623-825-9309
Practice Address - Fax:623-505-9822
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-17
Last Update Date:2014-07-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ0382213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
U32814Medicare UPIN
23124Medicare ID - Type Unspecified