Provider Demographics
NPI:1861617235
Name:HOFF, DANIEL RICHARD (PA-C)
Entity type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:RICHARD
Last Name:HOFF
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:679 COUNTY RD 124
Mailing Address - Street 2:PO BOX 207
Mailing Address - City:HESPERUS
Mailing Address - State:CO
Mailing Address - Zip Code:81326
Mailing Address - Country:US
Mailing Address - Phone:970-385-4501
Mailing Address - Fax:
Practice Address - Street 1:1000 RIM DR
Practice Address - Street 2:FORT LEWIS COLLEGE HEALTH CENTER
Practice Address - City:DURANGO
Practice Address - State:CO
Practice Address - Zip Code:81301
Practice Address - Country:US
Practice Address - Phone:970-247-7355
Practice Address - Fax:970-247-7621
Is Sole Proprietor?:No
Enumeration Date:2007-04-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO41363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant