Gary Franklin Hoffman, M.D.
Individual provider Active NPI Pediatrics Physician · Ketchum, ID
NPI 1194045252 · NPPES record last updated Jun 10, 2010
Key facts
- NPI
- 1194045252
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatrics Physician 208000000X
- License
- M5780 (ID)
- Practice address
- 235 Spur Lane
202
Ketchum, ID 83340-1529 - Phone
- (208) 725-5522
- Fax
- (208) 725-5522
- NPI assigned
- Jun 10, 2010
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| M5780 | ID | MD | Pediatrics Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | M5780 | ID | Yes |
Addresses
Primary practice location
235 Spur Lane
202
Ketchum, ID 83340-1529
Mailing address
PO Box 1529
Ketchum, ID 83340-1529
Phone (208) 725-5522
Other providers in Ketchum, ID
- Christine Hansen
- Stephanie B Hatzenbuehler
- Jane Ellen Henley
- Randall T Hermann
- James Walter Hodge
- Jon J Holmquist
- Jennie Hooper
- Ieg Zenergy, LLC
- Tomomi Ikawa
- Innerhealth MD PC
All providers in Ketchum, ID · Pediatrics Physician in Idaho
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 10, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.