Healthcare Provider Details

I. General information

NPI: 1013250950
Provider Name (Legal Business Name): JUSTIN PAUL HOOKER DPM, MS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/28/2013
Last Update Date: 03/12/2021
Certification Date: 03/12/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

670 PARK AVE
SHELBY MT
59474
US

IV. Provider business mailing address

PO BOX 990
SHELBY MT
59474-0990
US

V. Phone/Fax

Practice location:
  • Phone: 406-434-3110
  • Fax: 406-434-3143
Mailing address:
  • Phone: 406-434-3100
  • Fax: 406-434-3143

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213E00000X
TaxonomyPodiatrist
License NumberP-239
License Number StateID
# 2
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License NumberMED-POD-LIC-67915
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: