1356593594 NPI number — MICHAEL A. HOVEY MD PC

Table of content: MS. SUZANNE J. JAMES MSW, LCSW (NPI 1154520443)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1356593594 NPI number — MICHAEL A. HOVEY MD PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MICHAEL A. HOVEY MD PC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1356593594
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/16/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6829 N 72ND ST
Provider Second Line Business Mailing Address:
#5500
Provider Business Mailing Address City Name:
OMAHA
Provider Business Mailing Address State Name:
NE
Provider Business Mailing Address Postal Code:
68122-1723
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
402-572-3663
Provider Business Mailing Address Fax Number:
402-572-3438

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6829 N 72ND ST
Provider Second Line Business Practice Location Address:
#5500
Provider Business Practice Location Address City Name:
OMAHA
Provider Business Practice Location Address State Name:
NE
Provider Business Practice Location Address Postal Code:
68122-1723
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
402-572-3663
Provider Business Practice Location Address Fax Number:
402-572-3438
Provider Enumeration Date:
10/21/2008

Additional Information

Authorized Official

Authorized Official Last Name:
HOVEY
Authorized Official First Name:
MICHAEL
Authorized Official Middle Name:
A
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
402-572-3663

Provider Taxonomy Codes

  • Taxonomy code: 208600000X , with the licence number:  280194 , registered in the state of NE ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 10025379900 , issued by the state of ( NE ) . This identifiers is of the category "MEDICAID".




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