Individual
DR. MACKENZIE ROSS HOFFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4901 FOREST PARK AVE, DIV IM GENERAL MED, STE 241, SAINT LOUIS, MO 63108-1495
(314) 362-5060
(314) 996-3230
Mailing address
PO BOX 7412011, CHICAGO, IL 60674-2011
(314) 362-5060
(314) 996-3230
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
2020013462
MO
208D00000X
General Practice Physician
Primary
2020013462
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200084460
—
MO
Enumeration date
04/22/2015
Last updated
04/17/2025
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