Provider Demographics
NPI:1376769554
Name:CRAIG G HOOVER O D AND ASSOCIATES PLLC
Entity Type:Organization
Organization Name:CRAIG G HOOVER O D AND ASSOCIATES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:GERALD
Authorized Official - Last Name:HOOVER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:540-825-0541
Mailing Address - Street 1:691 LAUREL STREET
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 STREET
Practice Address - Street 2:SUITE 100
Practice Address - City:CULPEPER
Practice Address - State:VA
Practice Address - Zip Code:22701
Practice Address - Country:US
Practice Address - Phone:540-825-0541
Practice Address - Fax:540-829-5823
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-17
Last Update Date:2012-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
410001072Medicare ID - Type Unspecified
VA1246280001Medicare NSC