Provider Demographics
NPI:1386624062
Name:HOFFMAN, THOMAS LEE (DPM)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:LEE
Last Name:HOFFMAN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:320 PARK AVE
Mailing Address - Street 2:
Mailing Address - City:CLEARFIELD
Mailing Address - State:PA
Mailing Address - Zip Code:16830-2112
Mailing Address - Country:US
Mailing Address - Phone:814-765-3138
Mailing Address - Fax:814-765-3410
Practice Address - Street 1:320 PARK AVE
Practice Address - Street 2:
Practice Address - City:CLEARFIELD
Practice Address - State:PA
Practice Address - Zip Code:16830-2112
Practice Address - Country:US
Practice Address - Phone:814-765-3138
Practice Address - Fax:814-765-3410
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-19
Last Update Date:2008-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC-003105-L213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0010921230001Medicaid
PA211195OtherUPMC
408502OtherPA BLUE SHIELD
PA350015445OtherRAILROAD MEDICARE
PAT72790Medicare UPIN
PA408502Medicare PIN