Healthcare Provider Details

I. General information

NPI: 1417931056
Provider Name (Legal Business Name): DENISE R HOOKS-ANDERSON M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/06/2005
Last Update Date: 07/21/2022
Certification Date: 10/27/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1034 S BRENTWOOD BLVD STE 1120
SAINT LOUIS MO
63117-1211
US

IV. Provider business mailing address

1008 S SPRING SLUCARE ACADEMIC PAVILLION
SAINT LOUIS MO
63110
US

V. Phone/Fax

Practice location:
  • Phone: 314-977-4600
  • Fax: 314-726-1653
Mailing address:
  • Phone: 314-977-8485
  • Fax: 314-977-5268

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number2000148618
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: