Provider Demographics
NPI:1285645176
Name:HOVIS, JENNIFER COICAN (DO)
Entity type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:COICAN
Last Name:HOVIS
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1723 W 32ND ST
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44113-2930
Mailing Address - Country:US
Mailing Address - Phone:216-961-5080
Mailing Address - Fax:
Practice Address - Street 1:8787 BROOKPARK ROAD
Practice Address - Street 2:
Practice Address - City:PARMA
Practice Address - State:OH
Practice Address - Zip Code:44129-6809
Practice Address - Country:US
Practice Address - Phone:216-739-7000
Practice Address - Fax:216-739-7090
Is Sole Proprietor?:No
Enumeration Date:2006-08-10
Last Update Date:2012-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34-007991207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine