Healthcare Provider Details

I. General information

NPI: 1649535816
Provider Name (Legal Business Name): JEAN STUART HOVIS DVM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/12/2012
Last Update Date: 03/28/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1247 REDMON RD
MARSHALL NC
28753-5329
US

IV. Provider business mailing address

1247 REDMON RD
MARSHALL NC
28753-5329
US

V. Phone/Fax

Practice location:
  • Phone: 864-201-5261
  • Fax:
Mailing address:
  • Phone: 864-201-5261
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174M00000X
TaxonomyVeterinarian
License Number1816
License Number StateSC
# 2
Primary TaxonomyY
Taxonomy Code174M00000X
TaxonomyVeterinarian
License Number4281
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: