Provider Demographics
NPI:1841646148
Name:HOOKS DIABETES & MEDICINE CLINIC, PLLC
Entity type:Organization
Organization Name:HOOKS DIABETES & MEDICINE CLINIC, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:MS
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:D
Authorized Official - Last Name:HOOKS
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:662-260-4708
Mailing Address - Street 1:2625 TRACELAND DR STE A
Mailing Address - Street 2:
Mailing Address - City:TUPELO
Mailing Address - State:MS
Mailing Address - Zip Code:38801-4240
Mailing Address - Country:US
Mailing Address - Phone:662-260-4708
Mailing Address - Fax:662-260-4860
Practice Address - Street 1:2625 TRACELAND DR STE A
Practice Address - Street 2:
Practice Address - City:TUPELO
Practice Address - State:MS
Practice Address - Zip Code:38801-4240
Practice Address - Country:US
Practice Address - Phone:662-260-4708
Practice Address - Fax:662-260-4860
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-05
Last Update Date:2016-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSR867568261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS1174896245OtherNPI