Provider Demographics
NPI:1861406894
Name:HOOKER, PHILLIP ARON SR (MD, PHD)
Entity type:Individual
Prefix:DR
First Name:PHILLIP
Middle Name:ARON
Last Name:HOOKER
Suffix:SR
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:730 MEDICAL CENTER DR
Mailing Address - Street 2:P O BOX 1235
Mailing Address - City:WEST POINT
Mailing Address - State:MS
Mailing Address - Zip Code:39773-9317
Mailing Address - Country:US
Mailing Address - Phone:662-494-7167
Mailing Address - Fax:662-494-6707
Practice Address - Street 1:730 MEDICAL CENTER DR
Practice Address - Street 2:
Practice Address - City:WEST POINT
Practice Address - State:MS
Practice Address - Zip Code:39773-9317
Practice Address - Country:US
Practice Address - Phone:662-494-7167
Practice Address - Fax:662-494-6707
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS9395174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MSB96975Medicare UPIN