Provider Demographics
NPI:1720039100
Name:HOOVER, GEOFFREY WAYNE (MD)
Entity Type:Individual
Prefix:DR
First Name:GEOFFREY
Middle Name:WAYNE
Last Name:HOOVER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:122 N BRYANT AVE
Mailing Address - Street 2:SUITE 1B
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73034-6303
Mailing Address - Country:US
Mailing Address - Phone:405-216-8960
Mailing Address - Fax:405-216-8965
Practice Address - Street 1:122 N BRYANT AVE
Practice Address - Street 2:SUITE 1B
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73034-6303
Practice Address - Country:US
Practice Address - Phone:405-216-8960
Practice Address - Fax:405-216-8965
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-12
Last Update Date:2007-07-25
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OK21239207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine