Provider Demographics
NPI:1871565465
Name:HOOPER, HALDEN WAYNE JR (MD)
Entity type:Individual
Prefix:DR
First Name:HALDEN
Middle Name:WAYNE
Last Name:HOOPER
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1156 NASHVILLE PIKE
Mailing Address - Street 2:
Mailing Address - City:GALLATIN
Mailing Address - State:TN
Mailing Address - Zip Code:37066-3110
Mailing Address - Country:US
Mailing Address - Phone:615-989-1088
Mailing Address - Fax:615-823-2060
Practice Address - Street 1:1156 NASHVILLE PIKE
Practice Address - Street 2:
Practice Address - City:GALLATIN
Practice Address - State:TN
Practice Address - Zip Code:37066-3110
Practice Address - Country:US
Practice Address - Phone:615-989-1088
Practice Address - Fax:615-823-2060
Is Sole Proprietor?:No
Enumeration Date:2006-02-07
Last Update Date:2020-02-05
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TN14654207QG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3198867Medicaid
TN3198867Medicare ID - Type Unspecified
TN3198867Medicaid