Provider Demographics
NPI:1386806941
Name:HOFFMANN, MARC S (MD)
Entity type:Individual
Prefix:
First Name:MARC
Middle Name:S
Last Name:HOFFMANN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Last Name:
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Mailing Address - Street 1:9200 INDIAN CREEK PKWY
Mailing Address - Street 2:STE. 300, BLDG. 9
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66210-2036
Mailing Address - Country:US
Mailing Address - Phone:913-574-2800
Mailing Address - Fax:913-574-2336
Practice Address - Street 1:12200 W 110TH ST
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66210-4045
Practice Address - Country:US
Practice Address - Phone:913-574-2650
Practice Address - Fax:913-574-2769
Is Sole Proprietor?:No
Enumeration Date:2008-06-25
Last Update Date:2016-05-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KS0438229207RH0003X
MO2015019920207RH0003X
PAMD441770207RH0003X
TXP3349207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO1386806941Medicaid
KS201114770AMedicaid
MO1386806941Medicaid