Healthcare Provider Details

I. General information

NPI: 1700814555
Provider Name (Legal Business Name): JASON L HOFFMANN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/29/2006
Last Update Date: 01/06/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10500 QUIVIRA RD
OVERLAND PARK KS
66215-2306
US

IV. Provider business mailing address

8717 W 110TH ST SUITE 600
OVERLAND PARK KS
66210-2144
US

V. Phone/Fax

Practice location:
  • Phone: 913-428-2900
  • Fax: 913-428-2951
Mailing address:
  • Phone: 913-428-2900
  • Fax: 913-428-2951

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number2007011375
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number04-37608
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: