Provider Demographics
NPI:1134181639
Name:HOEFER, MARK L (MD)
Entity type:Individual
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First Name:MARK
Middle Name:L
Last Name:HOEFER
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Gender:M
Credentials:MD
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Mailing Address - Street 1:3707 N 7TH ST
Mailing Address - Street 2:STE. 200
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85014-5095
Mailing Address - Country:US
Mailing Address - Phone:602-264-9100
Mailing Address - Fax:602-265-6955
Practice Address - Street 1:1520 S DOBSON RD
Practice Address - Street 2:STE 302
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85202-4725
Practice Address - Country:US
Practice Address - Phone:480-461-1088
Practice Address - Fax:480-461-1657
Is Sole Proprietor?:No
Enumeration Date:2006-04-03
Last Update Date:2014-04-08
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Provider Licenses
StateLicense IDTaxonomies
AZ11108207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZC99649Medicare UPIN