Provider Demographics
NPI:1306488739
Name:HOFTB ANESTHESIA LLC
Entity type:Organization
Organization Name:HOFTB ANESTHESIA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE ANESTHETIST
Authorized Official - Prefix:
Authorized Official - First Name:DEONNA
Authorized Official - Middle Name:
Authorized Official - Last Name:CARLSON
Authorized Official - Suffix:
Authorized Official - Credentials:CRNA
Authorized Official - Phone:602-450-9862
Mailing Address - Street 1:8311 E VIA DE VENTURA APT 2060
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85258-6617
Mailing Address - Country:US
Mailing Address - Phone:602-350-9862
Mailing Address - Fax:
Practice Address - Street 1:6320 W UNION HILLS DR STE 1400B
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85308-1061
Practice Address - Country:US
Practice Address - Phone:623-688-5400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-17
Last Update Date:2019-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty