Healthcare Provider Details

I. General information

NPI: 1659373934
Provider Name (Legal Business Name): ROBERT C HOFFMAN M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/01/2005
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

615 E OKLAHOMA AVE STE 202
ENID OK
73701-5952
US

IV. Provider business mailing address

615 EAST OKLAHOMA #202
ENID OK
73701
US

V. Phone/Fax

Practice location:
  • Phone: 580-233-3230
  • Fax: 580-233-0698
Mailing address:
  • Phone: 580-233-3230
  • Fax: 580-233-0698

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number8562
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: