Provider Demographics
NPI:1659373934
Name:HOFFMAN, ROBERT C (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:C
Last Name:HOFFMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:615 EAST OKLAHOMA
Mailing Address - Street 2:#202
Mailing Address - City:ENID
Mailing Address - State:OK
Mailing Address - Zip Code:73701
Mailing Address - Country:US
Mailing Address - Phone:580-233-3230
Mailing Address - Fax:580-233-0698
Practice Address - Street 1:615 E OKLAHOMA AVE
Practice Address - Street 2:STE 202
Practice Address - City:ENID
Practice Address - State:OK
Practice Address - Zip Code:73701-5952
Practice Address - Country:US
Practice Address - Phone:580-233-3230
Practice Address - Fax:580-233-0698
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-01
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK8562208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OKD34806Medicare UPIN