Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204D00000X | Neuromusculoskeletal Medicine (NMM) | 1214 | AZ |
NPI | 1003875790 |
---|---|
Provider Name | Dr. Craig Edward Hoffbauer |
First Address | Cottonwood, AZ 86326-4078 |
Second Address | Cottonwood, AZ 86326-4073 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/03/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E44474 | (02) | AZ |