Healthcare Provider Details

I. General information

NPI: 1639499379
Provider Name (Legal Business Name): ROBERT SCOTT HOOPER DPH.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/04/2010
Last Update Date: 06/04/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5915 W MEMORIAL RD SUITE 110
OKLAHOMA CITY OK
73142-2015
US

IV. Provider business mailing address

16212 STILLMEADOWS DR
EDMOND OK
73013-9410
US

V. Phone/Fax

Practice location:
  • Phone: 405-773-2300
  • Fax: 405-621-5440
Mailing address:
  • Phone: 405-773-2300
  • Fax: 405-621-5440

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number11392
License Number StateOK
# 2
Primary TaxonomyN
Taxonomy Code1835X0200X
TaxonomyOncology Pharmacist
License Number11392
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: