Provider Demographics
NPI:1851616379
Name:HOFFMAN, STACEY (MD)
Entity type:Individual
Prefix:
First Name:STACEY
Middle Name:
Last Name:HOFFMAN
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4126 N. HOLLAND SYLVANIA RD
Mailing Address - Street 2:SUITE 220
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43623
Mailing Address - Country:US
Mailing Address - Phone:419-885-8449
Mailing Address - Fax:419-882-7621
Practice Address - Street 1:4126 N. HOLLAND SYLVANIA RD
Practice Address - Street 2:SUITE 220
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43623
Practice Address - Country:US
Practice Address - Phone:419-885-8449
Practice Address - Fax:419-882-7621
Is Sole Proprietor?:No
Enumeration Date:2010-03-29
Last Update Date:2025-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.123795208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation