Healthcare Provider Details

I. General information

NPI: 1881693281
Provider Name (Legal Business Name): JESSE HOOVER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/18/2005
Last Update Date: 10/09/2023
Certification Date: 10/09/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

503 N 21ST ST
CAMP HILL PA
17011-2204
US

IV. Provider business mailing address

4085 CAISSONS CT
ENOLA PA
17025-1477
US

V. Phone/Fax

Practice location:
  • Phone: 717-763-2126
  • Fax: 717-975-0779
Mailing address:
  • Phone: 717-728-1855
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberBH8335564
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code207LC0200X
TaxonomyCritical Care Medicine (Anesthesiology) Physician
License NumberMD421700
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: