Provider Demographics
NPI:1912043977
Name:HOOPER, JAMES FULLERTON IV (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:FULLERTON
Last Name:HOOPER
Suffix:IV
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1001 MIMOSA PARK ROAD
Mailing Address - Street 2:
Mailing Address - City:TUSCALOOSA
Mailing Address - State:AL
Mailing Address - Zip Code:35405
Mailing Address - Country:US
Mailing Address - Phone:205-393-1776
Mailing Address - Fax:205-752-6410
Practice Address - Street 1:1001 MIMOSA PARK ROAD
Practice Address - Street 2:
Practice Address - City:TUSCALOOSA
Practice Address - State:AL
Practice Address - Zip Code:35405
Practice Address - Country:US
Practice Address - Phone:205-393-1776
Practice Address - Fax:205-752-6410
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-29
Last Update Date:2011-03-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AL126182084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL12618OtherALABAMA MEDICAL BOARD
C75817Medicare UPIN
AL12618OtherALABAMA MEDICAL BOARD