Provider Demographics
NPI:1548556244
Name:HOOD, JAMES LEE JR (OTT)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:LEE
Last Name:HOOD
Suffix:JR
Gender:M
Credentials:OTT
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Mailing Address - Street 1:1534 ELIZABETH AVE STE 301
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71101-4531
Mailing Address - Country:US
Mailing Address - Phone:318-629-5001
Mailing Address - Fax:318-629-5020
Practice Address - Street 1:1500 LINE AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71101-4639
Practice Address - Country:US
Practice Address - Phone:318-635-3052
Practice Address - Fax:318-635-3072
Is Sole Proprietor?:No
Enumeration Date:2011-06-22
Last Update Date:2020-07-31
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
LAOTT.200440225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA3C525B103Medicare PIN