Provider Demographics
NPI:1144223272
Name:HOFFMANN, MARK FREDERICK (MD)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:FREDERICK
Last Name:HOFFMANN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:2710 E HARNEY ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:LARAMIE
Mailing Address - State:WY
Mailing Address - Zip Code:82072-2884
Mailing Address - Country:US
Mailing Address - Phone:307-745-8991
Mailing Address - Fax:307-745-8167
Practice Address - Street 1:2710 E HARNEY ST
Practice Address - Street 2:SUITE 100
Practice Address - City:LARAMIE
Practice Address - State:WY
Practice Address - Zip Code:82072-2884
Practice Address - Country:US
Practice Address - Phone:307-745-8991
Practice Address - Fax:307-745-8167
Is Sole Proprietor?:No
Enumeration Date:2005-05-23
Last Update Date:2019-09-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WYTL2023207V00000X
CAC158387207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology