Healthcare Provider Details

I. General information

NPI: 1285816702
Provider Name (Legal Business Name): PENNY L. HOOVER, M.D., P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/27/2007
Last Update Date: 11/27/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7936 US HWY 277
ELGIN OK
73538
US

IV. Provider business mailing address

PO BOX 429
ELGIN OK
73538-0429
US

V. Phone/Fax

Practice location:
  • Phone: 580-492-6900
  • Fax: 580-492-6902
Mailing address:
  • Phone: 580-492-6900
  • Fax: 580-492-6902

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number19634
License Number StateOK

VIII. Authorized Official

Name: DR. PENNY LYNN HOOVER
Title or Position: OWNER
Credential: M.D.
Phone: 580-492-6900