Healthcare Provider Details

I. General information

NPI: 1871938910
Provider Name (Legal Business Name): TARA HOOK M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/02/2013
Last Update Date: 07/24/2026
Certification Date: 07/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4631 SAVANNAH HWY
NORTH SC
29112-8180
US

IV. Provider business mailing address

86 WREN ST
BARNWELL SC
29812-1529
US

V. Phone/Fax

Practice location:
  • Phone: 803-247-2428
  • Fax:
Mailing address:
  • Phone: 803-259-5762
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number40303
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: