Healthcare Provider Details

I. General information

NPI: 1245332881
Provider Name (Legal Business Name): DAVID C HOFFMAN D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/03/2006
Last Update Date: 11/27/2023
Certification Date: 09/11/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3000 S STATE ROAD 135 SUITE 310
GREENWOOD IN
46143-9825
US

IV. Provider business mailing address

6626 E 75TH ST SUITE 500
INDIANAPOLIS IN
46250-2805
US

V. Phone/Fax

Practice location:
  • Phone: 317-497-2400
  • Fax: 317-497-2515
Mailing address:
  • Phone: 317-621-7588
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number02003112A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: