Healthcare Provider Details

I. General information

NPI: 1992786198
Provider Name (Legal Business Name): THERESA K HOFFMAN DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/07/2005
Last Update Date: 01/09/2025
Certification Date: 01/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10215 AUBURN PARK DR
FORT WAYNE IN
46825-2387
US

IV. Provider business mailing address

6920 POINTE INVERNESS WAY STE 200
FORT WAYNE IN
46804-7934
US

V. Phone/Fax

Practice location:
  • Phone: 260-234-5400
  • Fax: 260-234-5110
Mailing address:
  • Phone: 260-479-3516
  • Fax: 260-479-3520

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number02001618A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: