Provider Demographics
NPI:1871564096
Name:HOOPER, DWIGHT EDWARD (MD)
Entity type:Individual
Prefix:
First Name:DWIGHT
Middle Name:EDWARD
Last Name:HOOPER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:810 SAINT VINCENTS DR
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35205-1601
Mailing Address - Country:US
Mailing Address - Phone:205-930-2456
Mailing Address - Fax:205-930-2469
Practice Address - Street 1:810 SAINT VINCENTS DR
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35205-1601
Practice Address - Country:US
Practice Address - Phone:205-930-2456
Practice Address - Fax:205-930-2469
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-27
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL18618207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL009979695Medicaid
AL051500989Medicaid
ALBH1214016OtherDEA
ALBH1214016OtherDEA
ALBH1214016OtherDEA
ALF67596Medicare UPIN