Provider Demographics
NPI:1457590952
Name:HOOTON, MICHELLE G
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:G
Last Name:HOOTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:DEVLYNN
Other - Middle Name:MICHELLE
Other - Last Name:CATES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1835 CHATTANOOGA VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:FLINTSTONE
Mailing Address - State:GA
Mailing Address - Zip Code:30725-2022
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4062 HIXSON PIKE
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37415-3110
Practice Address - Country:US
Practice Address - Phone:423-877-3562
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-07
Last Update Date:2012-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH0187031835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist