Provider Demographics
NPI:1104853605
Name:HOOVER, CRAIG GERALD (OD)
Entity Type:Individual
Prefix:DR
First Name:CRAIG
Middle Name:GERALD
Last Name:HOOVER
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:691 LAUREL ST.
Mailing Address - Street 2:SUITE 100
Mailing Address - City:CULPEPER
Mailing Address - State:VA
Mailing Address - Zip Code:22701
Mailing Address - Country:US
Mailing Address - Phone:540-825-0541
Mailing Address - Fax:540-829-5823
Practice Address - Street 1:691 LAUREL ST
Practice Address - Street 2:SUITE 100
Practice Address - City:CULPEPER
Practice Address - State:VA
Practice Address - Zip Code:22701-3909
Practice Address - Country:US
Practice Address - Phone:540-825-0541
Practice Address - Fax:540-829-5823
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2012-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0618000484152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA009233920Medicaid
VA410038493OtherRAILROAD MEDICARE
VA1246280001OtherMEDICARE DMERC
VA232671OtherBLUE CROSS BLUE SHIELD
VA410001072Medicare ID - Type Unspecified
VA410038493OtherRAILROAD MEDICARE