Individual
DR. KENNETH ARTHUR HOOSE JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2675 N DECATUR RD, SUITE 607, DECATUR, GA 30033-6131
(404) 501-7640
(404) 501-7601
Mailing address
2675 N DECATUR RD, SUITE 607, DECATUR, GA 30033-6131
(404) 501-7640
(404) 501-7601
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
10962
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00098876A
—
GA
01
—
048575
BLUE SHIELD
GA
Enumeration date
04/03/2006
Last updated
02/28/2008
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