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General NPI Number Information
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NPI Number | 1821611419
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Entity Type | Individual
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Provider Name | NICHOLAS REEDE HOFFSOMMER DO
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Gender | Male
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Dates
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Enumeration Date | 05/19/2020
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Last Update Date | 02/25/2025
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Provider Practice Location Address
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Address Line | 1200 CHILDRENS AVE
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City | OKLAHOMA CITY
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State | OK
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Zip | 73104-4637
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Country | US
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Telephone | 405-271-4700
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Fax |
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Provider Business Mailing Address
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Address Line | 405 S OKLAHOMA AVE
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City | CHEROKEE
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State | OK
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Zip | 73728-2545
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Country | US
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Telephone | 580-596-2800
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Fax | 580-596-2805
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 7343
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License Number State | OK
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