Healthcare Provider Details

I. General information

NPI: 1639378540
Provider Name (Legal Business Name): JEFFREY SPALDING HOVATER D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/12/2007
Last Update Date: 09/01/2021
Certification Date: 09/01/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1751 VETERANS DR STE 300
FLORENCE AL
35630-4930
US

IV. Provider business mailing address

1751 VETERANS DR STE 300
FLORENCE AL
35630-4930
US

V. Phone/Fax

Practice location:
  • Phone: 256-718-3200
  • Fax: 256-246-3297
Mailing address:
  • Phone: 256-718-3200
  • Fax: 256-246-3297

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberDO.971
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: