Provider Demographics
NPI:1699762369
Name:STOFFEL, THOMAS J (MD)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:J
Last Name:STOFFEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 115
Mailing Address - Street 2:
Mailing Address - City:HIAWATHA
Mailing Address - State:IA
Mailing Address - Zip Code:52233-0115
Mailing Address - Country:US
Mailing Address - Phone:319-826-3763
Mailing Address - Fax:888-609-6019
Practice Address - Street 1:500 JOHN DEERE RD
Practice Address - Street 2:
Practice Address - City:MOLINE
Practice Address - State:IL
Practice Address - Zip Code:61265-6892
Practice Address - Country:US
Practice Address - Phone:309-779-5090
Practice Address - Fax:309-779-5072
Is Sole Proprietor?:No
Enumeration Date:2005-09-28
Last Update Date:2022-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA228992085R0001X
IL036-0539602085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0917682Medicaid
IL036053960Medicaid
IL036053960Medicaid
IAA02673Medicare UPIN
ILL18312Medicare PIN