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General NPI Number Information
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NPI Number | 1043346661
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Entity Type | Individual
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Provider Name | JOHN EDWARD HOOK O.D.
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Gender | Male
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Dates
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Enumeration Date | 02/26/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2415 SAGAMORE PKWY S
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City | LAFAYETTE
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State | IN
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Zip | 47905-5124
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Country | US
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Telephone | 765-447-2105
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Fax |
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Provider Business Mailing Address
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Address Line | 2411 GRANT BLVD
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City | LEBANON
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State | IN
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Zip | 46052-1271
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Country | US
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Telephone | 765-483-9641
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 18002735B
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License Number State | IN
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