Provider Demographics
NPI:1710315809
Name:HOOKS, DIANNE RENEE (DO)
Entity Type:Individual
Prefix:MRS
First Name:DIANNE
Middle Name:RENEE
Last Name:HOOKS
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:302 S GREEN ST
Mailing Address - Street 2:
Mailing Address - City:SWAINSBORO
Mailing Address - State:GA
Mailing Address - Zip Code:30401-3099
Mailing Address - Country:US
Mailing Address - Phone:478-289-8289
Mailing Address - Fax:912-478-2537
Practice Address - Street 1:302 S GREEN ST
Practice Address - Street 2:
Practice Address - City:SWAINSBORO
Practice Address - State:GA
Practice Address - Zip Code:30401-3099
Practice Address - Country:US
Practice Address - Phone:478-289-8289
Practice Address - Fax:912-478-2537
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-29
Last Update Date:2013-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA1291156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician