| Brian Hofung, Md, Pllc | |
|
602 N Roan St Suite #2 Johnson City TN 37601-4763 | |
| (423) 979-0466 | |
| (423) 979-0467 |
| Full Name | Brian Hofung, Md, Pllc |
|---|---|
| Speciality | Clinic/center |
| Location | 602 N Roan St, Johnson City, Tennessee |
| Authorized Official Name and Position | Brian Christopher Hofung (OWNER) |
| Authorized Official Contact | 4239790466 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Brian Hofung, Md, Pllc 602 N Roan St Suite #2 Johnson City TN 37601-4763 Ph: (423) 979-0466 | Brian Hofung, Md, Pllc 602 N Roan St Suite #2 Johnson City TN 37601-4763 Ph: (423) 979-0466 |
| NPI Number | 1457585770 |
|---|---|
| Provider Enumeration Date | 05/14/2009 |
| Last Update Date | 05/14/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457585770 | NPI | - | NPPES |
| 3841838 | Medicaid | TN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | MD31830 (Tennessee) | Primary |
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