Basic Information
| Provider Information | |||||||||
| NPI: | 1518197300 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | VERNON C HOFMANN MD INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 720780 | ||||||||
| Address2: | |||||||||
| City: | NORMAN | ||||||||
| State: | OK | ||||||||
| PostalCode: | 730704604 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4053607576 | ||||||||
| FaxNumber: | 4053607762 | ||||||||
| Practice Location | |||||||||
| Address1: | 2825 PARKLAWN DR | ||||||||
| Address2: | |||||||||
| City: | MIDWEST CITY | ||||||||
| State: | OK | ||||||||
| PostalCode: | 731104201 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4053607576 | ||||||||
| FaxNumber: | 4053607762 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/15/2009 | ||||||||
| LastUpdateDate: | 11/16/2009 | ||||||||
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| AuthorizedOfficialLastName: | HOFMANN | ||||||||
| AuthorizedOfficialFirstName: | VERNON | ||||||||
| AuthorizedOfficialMiddleName: | C | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 4053607576 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | OK | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Anesthesiology |
No ID Information.