Provider Demographics
NPI:1356385645
Name:HOOS, RICHARD T (MD)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:T
Last Name:HOOS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 1068
Mailing Address - Street 2:
Mailing Address - City:ROLLA
Mailing Address - State:MO
Mailing Address - Zip Code:65402-1068
Mailing Address - Country:US
Mailing Address - Phone:615-855-1374
Mailing Address - Fax:615-855-1352
Practice Address - Street 1:118 WESSINGTON PL
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:TN
Practice Address - Zip Code:37075-3086
Practice Address - Country:US
Practice Address - Phone:615-855-1374
Practice Address - Fax:615-855-1352
Is Sole Proprietor?:No
Enumeration Date:2006-06-16
Last Update Date:2018-10-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TN112232084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN130003873OtherRR MEDICARE
TN130026234OtherRR MEDICARE
TN4082460OtherAETNA
TN3010187Medicaid
TN2008144OtherBCBS OF TN
TN4053302OtherBLUE CROSS BLUE SHIELD
TN3196507Medicaid
TN3196507Medicaid
TN3196507Medicare PIN
TN2008144OtherBCBS OF TN