Provider Demographics
NPI:1164486361
Name:HOOK, VICKI BAIR (MD)
Entity Type:Individual
Prefix:DR
First Name:VICKI
Middle Name:BAIR
Last Name:HOOK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:489 DEVON PARK DRIVE
Mailing Address - Street 2:SUITE 312
Mailing Address - City:WAYNE
Mailing Address - State:PA
Mailing Address - Zip Code:19087-1809
Mailing Address - Country:US
Mailing Address - Phone:610-964-1983
Mailing Address - Fax:610-964-1984
Practice Address - Street 1:489 DEVON PARK DRIVE
Practice Address - Street 2:SUITE 312
Practice Address - City:WAYNE
Practice Address - State:PA
Practice Address - Zip Code:19087-1809
Practice Address - Country:US
Practice Address - Phone:610-964-1983
Practice Address - Fax:610-964-1984
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD035160L2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
4088787OtherAETNA
C32216Medicare UPIN
157021Medicare ID - Type Unspecified