Provider Demographics
NPI:1376835256
Name:HOFFMAN, MEGAN M (MD)
Entity Type:Individual
Prefix:DR
First Name:MEGAN
Middle Name:M
Last Name:HOFFMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:SISTER MARY GRETCHEN
Other - Middle Name:
Other - Last Name:HOFFMAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:10711 E 11TH ST
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74128-3200
Mailing Address - Country:US
Mailing Address - Phone:918-583-7233
Mailing Address - Fax:918-583-7205
Practice Address - Street 1:10711 E 11TH ST
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74128-3200
Practice Address - Country:US
Practice Address - Phone:918-583-7233
Practice Address - Fax:918-583-7205
Is Sole Proprietor?:No
Enumeration Date:2011-05-10
Last Update Date:2021-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301104621207R00000X
OK37974207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0B96028OtherBCBS
MI0B96028Medicare PIN