Healthcare Provider Details

I. General information

NPI: 1689628521
Provider Name (Legal Business Name): DAVID A HOOVER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/22/2006
Last Update Date: 05/04/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6071 E WOODMEN RD SUITE 105
COLORADO SPRINGS CO
80923
US

IV. Provider business mailing address

6071 E WOODMEN RD SUITE 105
COLORADO SPRINGS CO
80923
US

V. Phone/Fax

Practice location:
  • Phone: 719-597-8704
  • Fax: 719-597-6864
Mailing address:
  • Phone: 719-597-8704
  • Fax: 719-597-6864

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number025562
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: