Provider Demographics
NPI:1336222694
Name:HOOKS, VENDIE HUDSON III (MD)
Entity Type:Individual
Prefix:DR
First Name:VENDIE
Middle Name:HUDSON
Last Name:HOOKS
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1348 WALTON WAY
Mailing Address - Street 2:SUITE 6500
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30901-5104
Mailing Address - Country:US
Mailing Address - Phone:706-722-2118
Mailing Address - Fax:706-722-0342
Practice Address - Street 1:1348 WALTON WAY
Practice Address - Street 2:SUITE 6500
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30901-5104
Practice Address - Country:US
Practice Address - Phone:706-722-2118
Practice Address - Fax:706-722-0342
Is Sole Proprietor?:No
Enumeration Date:2006-10-23
Last Update Date:2010-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA017026208C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA2089760OtherAETNA HMO
GA1591891003OtherCIGNA HMO
GA00201528BMedicaid
GA4138352OtherAETNA
GA1591891002OtherCIGNA
SC457030Medicaid
GA020005045Medicare ID - Type UnspecifiedRAILROAD
GAD29789Medicare UPIN
GA00201528BMedicaid