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General NPI Number Information
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NPI Number | 1710013222
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Entity Type | Individual
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Provider Name | HAROLD JEFFERY HOOVER OD
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Gender | Male
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Dates
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Enumeration Date | 02/26/2007
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 3450 WRIGHTSBORO RD JC PENNY OPTICAL
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City | AUGUSTA
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State | GA
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Zip | 30909-2516
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Country | US
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Telephone | 706-667-8336
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Fax | 706-863-1800
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Provider Business Mailing Address
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Address Line | 4091 PINE RIDGE RD
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City | APPLING
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State | GA
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Zip | 30802-4021
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Country | US
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Telephone | 706-284-8724
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Fax | 706-863-1800
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 1138
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License Number State | GA
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