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
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