Provider Demographics
NPI:1356394415
Name:FOOKS, HENRY JR (MD)
Entity type:Individual
Prefix:DR
First Name:HENRY
Middle Name:
Last Name:FOOKS
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:90 JACKSON PIKE
Mailing Address - Street 2:
Mailing Address - City:GALLIPOLIS
Mailing Address - State:OH
Mailing Address - Zip Code:45631-1560
Mailing Address - Country:US
Mailing Address - Phone:740-446-5890
Mailing Address - Fax:740-446-5532
Practice Address - Street 1:224 COLUMBUS RD
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:OH
Practice Address - Zip Code:45701-1334
Practice Address - Country:US
Practice Address - Phone:740-589-3100
Practice Address - Fax:740-589-3132
Is Sole Proprietor?:No
Enumeration Date:2006-05-18
Last Update Date:2022-04-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH35-08-7648208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
P00373066OtherRR MEDICARE
000000439218OtherANTHEM BCBS
1356394415OtherNPI
OH578765499OtherTRI CARE
OH2662622Medicaid
001870161OtherMOUNTAIN STATE BCBS
WV3810005680Medicaid
OH2662622Medicaid
P00373066OtherRR MEDICARE