Provider Demographics
NPI:1427009372
Name:HOOVLER, ANTHONY RAY (MD)
Entity Type:Individual
Prefix:
First Name:ANTHONY
Middle Name:RAY
Last Name:HOOVLER
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 1:2512 WHEATON WAY
Mailing Address - Street 2:
Mailing Address - City:BREMERTON
Mailing Address - State:WA
Mailing Address - Zip Code:98310-3399
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2512 WHEATON WAY
Practice Address - Street 2:
Practice Address - City:BREMERTON
Practice Address - State:WA
Practice Address - Zip Code:98310-3399
Practice Address - Country:US
Practice Address - Phone:360-782-3700
Practice Address - Fax:360-782-3797
Is Sole Proprietor?:No
Enumeration Date:2006-05-15
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00045941207R00000X, 207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
P00309799OtherRAILROAD MEDICARE
WA205200OtherLABOR & INDUSTRIES
7639806OtherAETNA
WA8444218Medicaid
5389HOOtherREGENCE BLUE SHIELD
5389HOOtherREGENCE BLUE SHIELD
WAG8862004Medicare PIN
WAG8858246Medicare PIN
P00309799OtherRAILROAD MEDICARE
WAG8858247Medicare PIN
WAG8860585Medicare PIN
7639806OtherAETNA
WAG8858248Medicare PIN