Basic Information
| Provider Information | |||||||||
| NPI: | 1114905973 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HOOVER | ||||||||
| FirstName: | CRAIG | ||||||||
| MiddleName: | A | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3375 N CAMPBELL AVE | ||||||||
| Address2: | |||||||||
| City: | TUCSON | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 857192306 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5203203918 | ||||||||
| FaxNumber: | 5206242798 | ||||||||
| Practice Location | |||||||||
| Address1: | 445 N SILVERBELL RD STE 201 | ||||||||
| Address2: | |||||||||
| City: | TUCSON | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 857452686 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5203961370 | ||||||||
| FaxNumber: | 5203961375 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/03/2006 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RC0000X | 21932 | AZ | N | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease | 207RI0011X | 21932 | AZ | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Interventional Cardiology |
ID Information
| ID | Type | State | Issuer | Description | 159906 | 05 | AZ | MEDICAID |