Healthcare Provider Details

I. General information

NPI: 1972549921
Provider Name (Legal Business Name): ROSS G HOFFMAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/20/2006
Last Update Date: 06/23/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 AIRPORT RD
RIFLE CO
81650-8510
US

IV. Provider business mailing address

3150 N 12TH ST
GRAND JUNCTION CO
81506-2863
US

V. Phone/Fax

Practice location:
  • Phone: 970-254-1686
  • Fax: 970-254-1687
Mailing address:
  • Phone: 970-254-1686
  • Fax: 970-254-1687

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number34369
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: