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General NPI Number Information
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NPI Number | 1790746998
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Entity Type | Individual
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Provider Name | ERIC GLEN HOOVER MD
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Gender | Male
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Dates
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Enumeration Date | 03/29/2006
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Last Update Date | 01/27/2025
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Provider Practice Location Address
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Address Line | 205 N EAST AVE IMAGING SERVICES
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City | JACKSON
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State | MI
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Zip | 49201-1753
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Country | US
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Telephone | 517-783-2612
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Fax | 517-783-5991
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Provider Business Mailing Address
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Address Line | 2800 SPRING ARBOR RD STE 102 PO BOX 905
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City | JACKSON
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State | MI
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Zip | 49203-3895
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Country | US
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Telephone | 517-783-2612
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Fax | 517-783-5991
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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 | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 4301102215
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | MD60051003
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License Number State | WA
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