=====================================================
General NPI Number Information
=====================================================
NPI Number | 1154751824
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JAMIESON HOOKS
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/17/2013
-----------------------------------------------------
Last Update Date | 11/17/2013
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2270 WARRENSBURG RD
-----------------------------------------------------
City | DELAWARE
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 43015-1336
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 740-369-9614
-----------------------------------------------------
Fax | 740-363-5881
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 159 CHESHIRE CROSSING DR
-----------------------------------------------------
City | DELAWARE
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 43015-8299
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 616-901-5308
-----------------------------------------------------
Fax | 740-201-8033
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225X00000X
-----------------------------------------------------
Taxonomy Name | Occupational Therapist
-----------------------------------------------------
License Number | OT.008488
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 225XG0600X
-----------------------------------------------------
Taxonomy Name | Gerontology Occupational Therapist
-----------------------------------------------------
License Number | OT.008488
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 225XP0200X
-----------------------------------------------------
Taxonomy Name | Pediatric Occupational Therapist
-----------------------------------------------------
License Number | OT.008488
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------