Provider Demographics
NPI:1396825030
Name:ROSANNE J HOOKS MD PA
Entity Type:Organization
Organization Name:ROSANNE J HOOKS MD PA
Other - Org Name:INDEPENDENT PHYSICIANS GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:ROSANNE
Authorized Official - Middle Name:J
Authorized Official - Last Name:HOOKS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:843-464-1201
Mailing Address - Street 1:1004 S MAIN ST
Mailing Address - Street 2:BASILY BLDG
Mailing Address - City:MULLINS
Mailing Address - State:SC
Mailing Address - Zip Code:29574-3920
Mailing Address - Country:US
Mailing Address - Phone:843-464-1201
Mailing Address - Fax:843-464-1219
Practice Address - Street 1:1004 S MAIN ST
Practice Address - Street 2:BASILY BLDG
Practice Address - City:MULLINS
Practice Address - State:SC
Practice Address - Zip Code:29574-3920
Practice Address - Country:US
Practice Address - Phone:843-464-1201
Practice Address - Fax:843-464-1219
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ROSANNE J HOOKS MD PA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-10-17
Last Update Date:2008-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC110597207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCRHC119Medicaid
SCRHC119Medicaid