Provider Demographics
NPI:1609094986
Name:HOOVER, BRIAN J (DPM)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:J
Last Name:HOOVER
Suffix:
Gender:M
Credentials:DPM
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Mailing Address - Street 1:11166 STONE CREEK RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:HUNTINGDON
Mailing Address - State:PA
Mailing Address - Zip Code:16652-6464
Mailing Address - Country:US
Mailing Address - Phone:814-643-5565
Mailing Address - Fax:814-643-2607
Practice Address - Street 1:11166 STONE CREEK RIDGE RD
Practice Address - Street 2:
Practice Address - City:HUNTINGDON
Practice Address - State:PA
Practice Address - Zip Code:16652-6464
Practice Address - Country:US
Practice Address - Phone:814-643-5565
Practice Address - Fax:814-643-2607
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-23
Last Update Date:2018-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC-001976-L213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA251363650OtherCIGNA
TX0004390700OtherAETNA
PA21298OtherGEISSINGER HEALTH PLAN
PA251363650OtherHOP ADMINISTRATION
FL251363650OtherGENWORTH FINANCIAL
PA335768OtherHEALTH AMERICA
PA50001941OtherCAPITAL BLUE CROSS
PA0005070180003Medicaid
OH251363650OtherUNITED COMMERICAL TRAVELE
TX1295443OtherAAG BENEFIT PLAN ADMINIST
PA001522OtherBLUE SHIELD
SC480021319OtherRAILROAD MEDICARE
PA1000010001251363650OtherUNITED HEALTHCARE
PA251363650OtherSTATE FARM HEALTH INS
FL251363650OtherAMERICAHGENERAL LIFE
PA251363650OtherPA EMPLOYES BENEFIT FUND
GA251363650OtherUNITED HEALTHCARE
WA338060OtherCOMBINED INS CO