Provider Demographics
NPI:1659527430
Name:HOOTS, JESSICA ANN (MD)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:ANN
Last Name:HOOTS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5708 CHAPMAN MILL DR
Mailing Address - Street 2:APT 310
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852-5541
Mailing Address - Country:US
Mailing Address - Phone:804-938-9861
Mailing Address - Fax:
Practice Address - Street 1:5708 CHAPMAN MILL DR
Practice Address - Street 2:APT 310
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852-5541
Practice Address - Country:US
Practice Address - Phone:804-938-9861
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-13
Last Update Date:2011-05-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA645642085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology