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NPI 1366766917

NPI 1366766917 : DAVID AUSTIN HOOPER PA-C : FAYETTEVILLE, NC

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General NPI Number Information
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    NPI Number           |    1366766917
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    Entity Type          |    Individual 
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    Provider Name        |    DAVID AUSTIN HOOPER PA-C
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    03/24/2010
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    Last Update Date     |    10/16/2013
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Provider Practice Location Address
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    Address Line         |    2301 ROBESON ST SUITE 202
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    City                 |    FAYETTEVILLE
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    State                |    NC
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    Zip                  |    28305-5640
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    Country              |    US
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    Telephone            |    910-483-2556
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    Fax                  |    910-483-8756
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Provider Business Mailing Address
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    Address Line         |    PO BOX 64525 
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    City                 |    FAYETTEVILLE
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    State                |    NC
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    Zip                  |    28306-0525
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    Country              |    US
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    Telephone            |    910-483-2556
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    Fax                  |    910-483-8756
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    363A00000X
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    Taxonomy Name        |    Physician Assistant
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    License Number       |    0010-02256
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    License Number State |    NC
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