Provider Demographics
NPI:1487644019
Name:HOOKMAN, LAWRENCE (MD)
Entity Type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:
Last Name:HOOKMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 EXECUTIVE PARK DR
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:TN
Mailing Address - Zip Code:37716-6876
Mailing Address - Country:US
Mailing Address - Phone:865-494-9241
Mailing Address - Fax:865-494-0895
Practice Address - Street 1:110 EXECUTIVE PARK DR
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:TN
Practice Address - Zip Code:37716-6876
Practice Address - Country:US
Practice Address - Phone:865-494-9241
Practice Address - Fax:865-494-0895
Is Sole Proprietor?:No
Enumeration Date:2005-10-25
Last Update Date:2020-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN19139207RC0000X, 207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3859084Medicaid
TN3859084Medicaid
TN103I060793Medicare PIN
TNB64544Medicare UPIN
TN3859082Medicare PIN
P00841523Medicare PIN
060069069Medicare PIN