Provider Demographics
NPI:1902950181
Name:HOFFPAUIR, KYLE (OTR)
Entity Type:Individual
Prefix:MR
First Name:KYLE
Middle Name:
Last Name:HOFFPAUIR
Suffix:
Gender:M
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 COUNTY ROAD 7010
Mailing Address - Street 2:
Mailing Address - City:WYNNE
Mailing Address - State:AR
Mailing Address - Zip Code:72396-8470
Mailing Address - Country:US
Mailing Address - Phone:870-238-2233
Mailing Address - Fax:
Practice Address - Street 1:6 COUNTY ROAD 7010
Practice Address - Street 2:
Practice Address - City:WYNNE
Practice Address - State:AR
Practice Address - Zip Code:72396-8470
Practice Address - Country:US
Practice Address - Phone:870-238-2233
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-23
Last Update Date:2009-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AROTR 1671225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR5X236OtherBLUE CROSS & BLUE SHIELD
AR143676721Medicaid