Provider Demographics
NPI:1639499379
Name:HOOPER, ROBERT SCOTT (DPH)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:SCOTT
Last Name:HOOPER
Suffix:
Gender:M
Credentials:DPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16212 STILLMEADOWS DR
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73013-9410
Mailing Address - Country:US
Mailing Address - Phone:405-773-2300
Mailing Address - Fax:405-621-5440
Practice Address - Street 1:5915 W MEMORIAL RD
Practice Address - Street 2:SUITE 110
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73142-2015
Practice Address - Country:US
Practice Address - Phone:405-773-2300
Practice Address - Fax:405-621-5440
Is Sole Proprietor?:No
Enumeration Date:2010-06-04
Last Update Date:2010-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK11392183500000X, 1835X0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No1835X0200XPharmacy Service ProvidersPharmacistOncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK11392OtherOKLAHOMA STATE BOARD OF PHARMACY LICENSE