Provider Demographics
NPI:1366828667
Name:HOOKER, JAMES C JR
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:C
Last Name:HOOKER
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20005 MARK TWAIN ST
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48235-1676
Mailing Address - Country:US
Mailing Address - Phone:313-204-2067
Mailing Address - Fax:
Practice Address - Street 1:20005 MARK TWAIN ST
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48235-1676
Practice Address - Country:US
Practice Address - Phone:313-204-2067
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-10
Last Update Date:2015-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide