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NPI Code Detail

MEDICARE: DR. RYAN EARL HOOPER O.D.

MEDICARE: DR. RYAN EARL HOOPER O.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1152W00000XOptometrist6285OH

General Provider Information

NPI Number : 1104231265
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. RYAN EARL HOOPER O.D.
Provider Business Mailing Address
First Line : 19358 DETROIT RD STE A
Second Line :
City : ROCKY RIVER
State : OH
Zip : 44116-1802
Country : US
Telephone Number : 440-799-4311
Fax Number : 440-398-8040
Provider Business Practice Location Address
First Line : 19358 DETROIT RD STE A
Second Line :
City : ROCKY RIVER
State : OH
Zip : 44116-1802
Country : US
Telephone Number : 440-799-4311
Fax Number : 440-398-8040
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/27/2014
Last Update Date : 05/30/2023

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