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DR. GLEN THEODORE HOFSTROM MD
NPI 1619939550
Family Medicine in South Williamsport, PA

Active since April 05, 2006
145 SHAFFER ST, SOUTH WILLIAMSPORT, PA 17702(570) 326-2447(570) 326-1247 Get Directions Write a Review

NPPES record last updated: October 20, 2011. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Dr. Glen Theodore Hofstrom Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. GLEN THEODORE HOFSTROM MD (NPI 1619939550) is an individual family medicine provider in South Williamsport, Pennsylvania, licensed in Pennsylvania (MD019823E) and active in the NPI registry since April 2006.

NPPES Registry Identity

NPI1619939550
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameDR. GLEN THEODORE HOFSTROMCredential: MD
Location Address145 SHAFFER STSouth Williamsport, PA 17702-6727
Mailing Address1201 Grampian Blvd, Suite 1kWilliamsport, PA 17701-1900
Phone(570) 326-2447
Fax(570) 326-1247
Sole ProprietorNo
Enumeration DateApril 5, 2006
Last NPPES UpdateOctober 20, 2011
✔ NPI 1619939550 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in PA · MD019823E
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
145 SHAFFER ST, South Williamsport, PA 17702
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Other Identifiers 9

Other544226PA · Aetna
Other057619PA · Highmark Blue Shield
Medicaid0010813260001PA
Medicare PIN057619PA
Other001793PA · First Priority Health
Other1553395PA · Unitedhealthcare
OtherB34545PA · Healthamerica
Medicare UPINB34545
Medicare PIN080129309PA

Other Providers at the Same Location NPPES 15

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MICHELLE CAVANAUGH
Family Medicine
145 SHAFFER ST
SOUTH WILLIAMSPORT, PA 17702
Lycoming County (570) 326-2447
BROOKE MORGAN SMITH PA-C
Physician Assistant
145 SHAFFER ST
WILLIAMSPORT, PA 17702
Lycoming County (570) 327-1335
SAMUEL LOUIS ESPOSITO III PA-C
Physician Assistant
145 SHAFFER ST
WILLIAMSPORT, PA 17702
Lycoming County (570) 327-1335
HOLLY ELIZABETH STROUSE CRNP
Nurse Practitioner
145 SHAFFER ST
WILLIAMSPORT, PA 17702
Lycoming County (570) 327-1335
JAMES STEVEN BALDYS M.D.
Family Medicine
145 SHAFFER ST
WILLIAMSPORT, PA 17702
Lycoming County (570) 327-1335
THOMAS EVANS WALLACE MD
Family Medicine
145 SHAFFER ST
WILLIAMSPORT, PA 17702
Lycoming County (570) 327-1335
KELLIE LYNN KARSCHNER CRNP, MSN
Nurse Practitioner (Family)
145 SHAFFER ST
SOUTH WILLIAMSPORT, PA 17702
Lycoming County (570) 326-2447
DR. TERRY ALAN BELLES MD
Family Medicine
145 SHAFFER ST
SOUTH WILLIAMSPORT, PA 17702
Lycoming County (570) 326-2447

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Glen Hofstrom's NPI number?

The NPI number for Glen Hofstrom is 1619939550. It was assigned to this individual provider in the NPPES registry on April 5, 2006.

Where is Glen Hofstrom located?

Glen Hofstrom practices at 145 Shaffer St, South Williamsport, PA 17702. The listed phone number is (570) 326-2447.

What is Glen Hofstrom's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

When was this NPI record last updated?

The NPPES record for Glen Hofstrom was last updated on October 20, 2011. NPI Profile syncs with the weekly NPPES data releases published by CMS.