Provider Demographics
NPI:1528090321
Name:HOFFACKER, WYNNE ANN (MD)
Entity type:Individual
Prefix:DR
First Name:WYNNE
Middle Name:ANN
Last Name:HOFFACKER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:WYNNE
Other - Middle Name:ANN
Other - Last Name:BRINKS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:601 MEMORY LN
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402-2231
Mailing Address - Country:US
Mailing Address - Phone:717-812-4900
Mailing Address - Fax:717-255-0951
Practice Address - Street 1:105 4TH ST
Practice Address - Street 2:
Practice Address - City:EAST BERLIN
Practice Address - State:PA
Practice Address - Zip Code:17316-9638
Practice Address - Country:US
Practice Address - Phone:717-846-4644
Practice Address - Fax:717-259-7262
Is Sole Proprietor?:No
Enumeration Date:2006-07-06
Last Update Date:2024-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD057567L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA30123009 - CAREEXP.OtherAMERIHEALTH MERCY - WMG
PA30123010 - RDYCAREOtherAMERIHEALTH MERCY - WMG
PA80909OtherUNISON-WMG
PA95759OtherGEISINGER
PA30033OtherJOHNS HOPKINS
PAP002801OtherGATEWAY-WMG
PA001563960Medicaid
PA238929OtherMAMSI-WMG
PA842830OtherHIGHMARK BLUE SHIELD
MD542991OtherCAREFIRST MD BCBS
PA01059102OtherCAPITAL BLUE CROSS-WMG
PA1142351OtherAMERIHEALTH MERCY-WMG
PA4516556OtherAETNA
PA30123009 - CAREEXP.OtherAMERIHEALTH MERCY - WMG
PA842830OtherHIGHMARK BLUE SHIELD
PA001563960Medicaid