Provider Demographics
NPI:1093723934
Name:HOOPER, ALLEN STEPHEN (MD)
Entity Type:Individual
Prefix:DR
First Name:ALLEN
Middle Name:STEPHEN
Last Name:HOOPER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 99
Mailing Address - Street 2:
Mailing Address - City:KINSLEY
Mailing Address - State:KS
Mailing Address - Zip Code:67547-0099
Mailing Address - Country:US
Mailing Address - Phone:620-659-3621
Mailing Address - Fax:
Practice Address - Street 1:620 W 8TH
Practice Address - Street 2:
Practice Address - City:KINSLEY
Practice Address - State:KS
Practice Address - Zip Code:67547
Practice Address - Country:US
Practice Address - Phone:620-659-3621
Practice Address - Fax:620-659-3869
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2010-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS419570207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
D05227Medicare UPIN