Healthcare Provider Details

I. General information

NPI: 1396193447
Provider Name (Legal Business Name): JASON THOMAS HOFFMAN JR. D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/31/2016
Last Update Date: 12/29/2023
Certification Date: 03/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1620 8TH STREET
WICHITA FALLS TX
76301
US

IV. Provider business mailing address

1620 8TH STREET
WICHITA FALLS TX
76301
US

V. Phone/Fax

Practice location:
  • Phone: 940-764-5400
  • Fax: 940-764-5454
Mailing address:
  • Phone: 940-764-7230
  • Fax: 940-764-7255

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XS0114X
TaxonomyAdult Reconstructive Orthopaedic Surgery Physician
License NumberS9314
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: