Healthcare Provider Details

I. General information

NPI: 1619932134
Provider Name (Legal Business Name): RANDALL G HOFFMAN D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/18/2006
Last Update Date: 10/08/2025
Certification Date: 10/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 W US HIGHWAY 24
WOODLAND PARK CO
80863
US

IV. Provider business mailing address

PO BOX 35380
LAS VEGAS NV
89133-5380
US

V. Phone/Fax

Practice location:
  • Phone: 719-522-1133
  • Fax: 719-687-8919
Mailing address:
  • Phone: 719-463-5600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberDR.0036225
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: