Basic Information
| Provider Information | |||||||||
| NPI: | 1255587598 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HOOPER | ||||||||
| FirstName: | ELIZABETH | ||||||||
| MiddleName: | A | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4140 W MEMORIAL ROAD | ||||||||
| Address2: | SUITE 621 | ||||||||
| City: | OKLAHOMA CITY | ||||||||
| State: | OK | ||||||||
| PostalCode: | 731208365 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4057494231 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 4140 W MEMORIAL RD | ||||||||
| Address2: | SUITE 621 | ||||||||
| City: | OKLAHOMA CITY | ||||||||
| State: | OK | ||||||||
| PostalCode: | 731208365 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4057494231 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/18/2008 | ||||||||
| LastUpdateDate: | 08/01/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208600000X | 250774 | MA | N | Allopathic & Osteopathic Physicians | Surgery | 208600000X | 29998 | OK | Y | Allopathic & Osteopathic Physicians | Surgery |
No ID Information.