Provider Demographics
NPI:1659308229
Name:HOFFMAN, JAN M (MD)
Entity Type:Individual
Prefix:
First Name:JAN
Middle Name:M
Last Name:HOFFMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:4128 N PLUM TREE ST
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67226-3341
Mailing Address - Country:US
Mailing Address - Phone:316-804-6100
Mailing Address - Fax:316-804-6123
Practice Address - Street 1:700 MEDICAL CENTER DR
Practice Address - Street 2:SUITE 140
Practice Address - City:NEWTON
Practice Address - State:KS
Practice Address - Zip Code:67114-9013
Practice Address - Country:US
Practice Address - Phone:316-804-6100
Practice Address - Fax:316-804-6123
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2013-09-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KS25347207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS16982OtherCOVENTRY
KS200065OtherHPK
KS100175100BMedicaid
KS12149361OtherMULTIPLAN
KS3637OtherPHS
KS051766OtherBCBS
KS051766OtherBCBS
KS100175100BMedicaid