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NPI Code Detail

MEDICARE: PENNY L HOOVER MD

MEDICARE: PENNY L HOOVER MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician19634OK

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1457398240
Entity Type Code : Individual
Provider Name (Legal Business Name) : PENNY L HOOVER MD
Provider Business Mailing Address
First Line : 1122 NE 13TH ST
Second Line : ORI236
City : OKLAHOMA CITY
State : OK
Zip : 73117-1039
Country : US
Telephone Number : 580-248-2288
Fax Number :
Provider Business Practice Location Address
First Line : 1202 NW ARLINGTON AVE
Second Line :
City : LAWTON
State : OK
Zip : 73507-6537
Country : US
Telephone Number : 580-248-2288
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/01/2006
Last Update Date : 01/21/2011

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Directions to “ PENNY L HOOVER MD” Practice Location

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