Provider Demographics
NPI:1447235965
Name:HOFFERT, GAYLORD THOMAS (MD)
Entity type:Individual
Prefix:
First Name:GAYLORD
Middle Name:THOMAS
Last Name:HOFFERT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:293 OLMSTED BLVD STE 7
Mailing Address - Street 2:
Mailing Address - City:PINEHURST
Mailing Address - State:NC
Mailing Address - Zip Code:28374-9191
Mailing Address - Country:US
Mailing Address - Phone:910-295-3344
Mailing Address - Fax:910-295-3165
Practice Address - Street 1:293 OLMSTED BLVD STE 7
Practice Address - Street 2:
Practice Address - City:PINEHURST
Practice Address - State:NC
Practice Address - Zip Code:28374-9191
Practice Address - Country:US
Practice Address - Phone:910-295-3344
Practice Address - Fax:910-295-3165
Is Sole Proprietor?:No
Enumeration Date:2005-12-07
Last Update Date:2025-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV28721207RN0300X
KS04-48303207RN0300X
NC264798207RN0300X
WI74120207RN0300X
NY236787207RN0300X
NMMD2019-0048207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
7X2551Medicare ID - Type Unspecified
I41841Medicare UPIN