Organization
PREVENTATIVE MEDICINE AND PRIMARY CARE
Active
Organization
PREVENTATIVE MEDICINE AND PRIMARY CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICK DEAN HOOVER DO (OWNER)
(228) 497-2652
Entity
Organization
Contact information
Practice address
3300 LADNIER RD, GAUTIER, MS 39553-5909
(228) 497-2652
Mailing address
3300 LADNIER RD, GAUTIER, MS 39553-5909
(228) 497-2652
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
15373
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00118337
—
MS
Enumeration date
02/04/2014
Last updated
02/04/2014
Update your record
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