Healthcare Provider Details

I. General information

NPI: 1548511207
Provider Name (Legal Business Name): RYAN LLOYD HOOVER PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/20/2012
Last Update Date: 05/15/2025
Certification Date: 05/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 E ASH ST
GOLDSBORO NC
27530-5102
US

IV. Provider business mailing address

2604 MEDICAL OFFICE PL
GOLDSBORO NC
27534-9417
US

V. Phone/Fax

Practice location:
  • Phone: 800-243-0566
  • Fax: 252-243-1347
Mailing address:
  • Phone: 919-580-0004
  • Fax: 919-580-9099

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number1003801
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: