# PREVENTATIVE MEDICINE & PRIMARY CARE LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Gautier Medical Clinic
- **Organization subpart:** No

## Provider details

- **NPI number:** 1992728158
- **Authorized official:** DR. RICK D HOOVER DO (PHYSICIAN OWNER)
- **Authorized official phone:** (228) 497-2652

## Contact information

- **Practice address:** 3300 LADNIER RD, GAUTIER, MS 39553
- **Practice address phone:** (228) 497-2652
- **Practice address fax:** (228) 497-6253
- **Mailing address:** 3300 LADNIER RD, GAUTIER, MS 39553
- **Mailing address phone:** (228) 497-2652
- **Mailing address fax:** (228) 497-6253

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 07/26/2006
- **Last updated:** 08/22/2020