Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223E0200X | Endodontist | DS006918 | TN |
NPI | 1164509824 |
---|---|
Provider Name | Dr. John Pollard Hoover JR. |
First Address | Chattanooga, TN 37421-7802 |
Second Address | Chattanooga, TN 37421-7802 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/11/2006 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0171297 | (05) | TN |