Healthcare Provider Details

I. General information

NPI: 1255329702
Provider Name (Legal Business Name): GREGORY KEITH HOOVER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/10/2005
Last Update Date: 04/17/2025
Certification Date: 04/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12715 EVANS RD
KNOXVILLE TN
37934-4512
US

IV. Provider business mailing address

12715 EVANS RD
KNOXVILLE TN
37934-4512
US

V. Phone/Fax

Practice location:
  • Phone: 865-316-3650
  • Fax: 865-374-2114
Mailing address:
  • Phone: 865-316-3650
  • Fax: 865-374-2114

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number23756
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: