Provider Demographics
NPI:1902233596
Name:HOVER, JEFFERY S (DO)
Entity type:Individual
Prefix:
First Name:JEFFERY
Middle Name:S
Last Name:HOVER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:1101 PENINSULA DR STE 202
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16505-4169
Mailing Address - Country:US
Mailing Address - Phone:814-877-7290
Mailing Address - Fax:814-877-7280
Practice Address - Street 1:1101 PENINSULA DR STE 202
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16505-4169
Practice Address - Country:US
Practice Address - Phone:814-877-7290
Practice Address - Fax:814-877-7280
Is Sole Proprietor?:No
Enumeration Date:2013-09-27
Last Update Date:2024-07-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAOS024013207R00000X
HIAMD-539363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine