Provider Demographics
NPI:1013250950
Name:HOOKER, JUSTIN PAUL (DPM, MS)
Entity Type:Individual
Prefix:
First Name:JUSTIN
Middle Name:PAUL
Last Name:HOOKER
Suffix:
Gender:M
Credentials:DPM, MS
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 990
Mailing Address - Street 2:
Mailing Address - City:SHELBY
Mailing Address - State:MT
Mailing Address - Zip Code:59474-0990
Mailing Address - Country:US
Mailing Address - Phone:406-434-3100
Mailing Address - Fax:406-434-3143
Practice Address - Street 1:670 PARK AVE
Practice Address - Street 2:
Practice Address - City:SHELBY
Practice Address - State:MT
Practice Address - Zip Code:59474
Practice Address - Country:US
Practice Address - Phone:406-434-3110
Practice Address - Fax:406-434-3143
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-28
Last Update Date:2021-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDP-239213E00000X
MTMED-POD-LIC-67915213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Multi-Specialty