Healthcare Provider Details

I. General information

NPI: 1659308229
Provider Name (Legal Business Name): JAN M HOFFMAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2006
Last Update Date: 09/24/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 MEDICAL CENTER DR SUITE 140
NEWTON KS
67114-9013
US

IV. Provider business mailing address

4128 N PLUM TREE ST
WICHITA KS
67226-3341
US

V. Phone/Fax

Practice location:
  • Phone: 316-804-6100
  • Fax: 316-804-6123
Mailing address:
  • Phone: 316-804-6100
  • Fax: 316-804-6123

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number25347
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: