Healthcare Provider Details

I. General information

NPI: 1255303699
Provider Name (Legal Business Name): STEPHEN GLENN HOOKER M.D., M.P.H.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 02/01/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6000 W HIGHWAY 98 NAVAL HOSPITAL PENSACOLA
PENSACOLA FL
32512-0001
US

IV. Provider business mailing address

9769 JABIRU LN
PENSACOLA FL
32507-7203
US

V. Phone/Fax

Practice location:
  • Phone: 850-505-6924
  • Fax:
Mailing address:
  • Phone: 850-492-4189
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083P0901X
TaxonomyPublic Health & General Preventive Medicine Physician
License Number11239
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: