Provider Demographics
NPI:1356404032
Name:HOVEN, JOHN D (OD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:D
Last Name:HOVEN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 12TH AVE E
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:MN
Mailing Address - Zip Code:56308
Mailing Address - Country:US
Mailing Address - Phone:320-763-4321
Mailing Address - Fax:320-763-6921
Practice Address - Street 1:120 12TH AVE E
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:MN
Practice Address - Zip Code:56308-2528
Practice Address - Country:US
Practice Address - Phone:320-763-4321
Practice Address - Fax:320-763-6921
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-18
Last Update Date:2011-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2740152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN02S50HOOtherBCBS OF MN
MN1020816OtherPERFERRED ONE
MN22-12021OtherMEDICA
MN969718700Medicaid
MN127664OtherUCARE
MN410041603OtherRAILROAD MEDICARE
MNAVESISOther23375
MNHP29233OtherHEALTH PARTNERS
MN0307010153OtherPRIMEWEST
MN969718700Medicaid
MN02S50HOOtherBCBS OF MN