Healthcare Provider Details

I. General information

NPI: 1871565465
Provider Name (Legal Business Name): HALDEN WAYNE HOOPER JR. M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/07/2006
Last Update Date: 02/05/2020
Certification Date: 02/05/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1156 NASHVILLE PIKE
GALLATIN TN
37066-3110
US

IV. Provider business mailing address

1156 NASHVILLE PIKE
GALLATIN TN
37066-3110
US

V. Phone/Fax

Practice location:
  • Phone: 615-989-1088
  • Fax: 615-823-2060
Mailing address:
  • Phone: 615-989-1088
  • Fax: 615-823-2060

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QG0300X
TaxonomyGeriatric Medicine (Family Medicine) Physician
License Number14654
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: