Provider Demographics
NPI:1144864604
Name:HOFFMEISTER, JASON DAVID I (MSOTR/L)
Entity type:Individual
Prefix:MR
First Name:JASON
Middle Name:DAVID
Last Name:HOFFMEISTER
Suffix:I
Gender:M
Credentials:MSOTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3023 PORT ROYAL LN
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37938-4693
Mailing Address - Country:US
Mailing Address - Phone:865-684-9926
Mailing Address - Fax:
Practice Address - Street 1:3023 PORT ROYAL LN
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37938-4693
Practice Address - Country:US
Practice Address - Phone:865-684-9926
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-28
Last Update Date:2019-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNOT0000003670225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist