MEDICARE: ROSANNE J HOOKS MD PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	110597	SC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1073518486
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROSANNE J HOOKS MD PA

Provider Business Mailing Address
First Line	:	PO BOX 151
Second Line	:
City	:	NICHOLS
State	:	SC
Zip	:	29581-0151
Country	:	US
Telephone Number	:	843-464-1201
Fax Number	:	843-464-1219

Provider Business Practice Location Address
First Line	:	1004 S MAIN ST
Second Line	:
City	:	MULLINS
State	:	SC
Zip	:	29574-3920
Country	:	US
Telephone Number	:	843-464-1201
Fax Number	:	843-464-1219

Authorized Official
Title or Position	:	CFO
Name	:	MR. WAYNE HOOKS
Credential	:
Telephone Number	:	843-464-1201

Provider Enumeration Date	:	06/14/2005
Last Update Date	:	02/13/2008

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