Provider Demographics
NPI:1497703300
Name:VAN HOOK, FREDERICK W (MD)
Entity Type:Individual
Prefix:DR
First Name:FREDERICK
Middle Name:W
Last Name:VAN HOOK
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:PO BOX 17806
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85731-7806
Mailing Address - Country:US
Mailing Address - Phone:520-909-6453
Mailing Address - Fax:520-731-6177
Practice Address - Street 1:1200 N EL DORADO PL
Practice Address - Street 2:# B-250
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85715-4637
Practice Address - Country:US
Practice Address - Phone:520-731-1191
Practice Address - Fax:520-731-6177
Is Sole Proprietor?:No
Enumeration Date:2006-05-04
Last Update Date:2016-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ27831207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
H12465Medicare UPIN