Organization
KURT P HOFMANN MD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KURT P HOFMANN MD FACS (PHYSICIAN)
(866) 909-8354
Entity
Organization
Contact information
Practice address
303 HARRIS INDUSTRIAL BLVD, SUITE 3, VIDALIA, GA 30474-8845
(866) 909-8354
(912) 538-0770
Mailing address
303 HARRIS INDUSTRIAL BLVD, SUITE 3, VIDALIA, GA 30474-8850
(866) 909-8354
(912) 538-0770
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
051197
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000945106D
—
GA
01
—
051197
LICENSE
GA
01
—
341202
WELLCARE
GA
Enumeration date
10/23/2006
Last updated
06/21/2018
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