Provider Demographics
NPI:1396735957
Name:HOOPER, ROBERT GEORGE (MD)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:GEORGE
Last Name:HOOPER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10277 N 92ND ST
Mailing Address - Street 2:SUITE 103
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85258-4564
Mailing Address - Country:US
Mailing Address - Phone:480-767-8811
Mailing Address - Fax:480-657-0737
Practice Address - Street 1:10277 N 92ND ST
Practice Address - Street 2:SUITE 103
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85258-4564
Practice Address - Country:US
Practice Address - Phone:480-767-8811
Practice Address - Fax:480-657-0737
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-25
Last Update Date:2020-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ11320207RP1001X, 207RS0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ225971001Medicaid
AZ290008359OtherRAILROAD MEDICARE
AZ225971001Medicaid
AZD37042Medicare UPIN