Healthcare Provider Details

I. General information

NPI: 1164573994
Provider Name (Legal Business Name): MARK JOHN HOVEE PSYD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/16/2007
Last Update Date: 03/06/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1425 KY HWY 40W
STAFFORDVILLE KY
41256
US

IV. Provider business mailing address

PO BOX 51
PAINTSVILLE KY
41240-0051
US

V. Phone/Fax

Practice location:
  • Phone: 606-297-7315
  • Fax:
Mailing address:
  • Phone: 606-297-7315
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number1063
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: