Healthcare Provider Details

I. General information

NPI: 1154646206
Provider Name (Legal Business Name): TODD A HOOVER, MD, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/01/2010
Last Update Date: 05/04/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 CENTENNIAL RD
PENN VALLEY PA
19072-1408
US

IV. Provider business mailing address

900 CENTENNIAL RD
PENN VALLEY PA
19072-1408
US

V. Phone/Fax

Practice location:
  • Phone: 610-209-8711
  • Fax:
Mailing address:
  • Phone: 610-209-8711
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD035426E
License Number StatePA

VIII. Authorized Official

Name: TODD ALAN HOOVER
Title or Position: OWNER
Credential: M.D.
Phone: 610-209-8711