Healthcare Provider Details

I. General information

NPI: 1659300986
Provider Name (Legal Business Name): LANCE H HOFFMAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2006
Last Update Date: 03/07/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

450 E 23RD ST
FREMONT NE
68025-2303
US

IV. Provider business mailing address

450 E 23RD ST
FREMONT NE
68025-2303
US

V. Phone/Fax

Practice location:
  • Phone: 402-721-1610
  • Fax: 402-727-3433
Mailing address:
  • Phone: 402-721-1610
  • Fax: 402-727-3433

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number21706
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: