1225060437 NPI number — JAMES VANHOOK MD

Table of content: JAMES VANHOOK MD (NPI 1225060437)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1225060437 NPI number — JAMES VANHOOK MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
VANHOOK
Provider First Name:
JAMES
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1225060437
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/27/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3355 GLENDALE AVE FL 3
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
TOLEDO
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
43614-2426
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
419-291-3121
Provider Business Mailing Address Fax Number:
419-291-2621

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2142 N COVE BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TOLEDO
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
43606
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
419-291-3121
Provider Business Practice Location Address Fax Number:
419-291-2621
Provider Enumeration Date:
07/07/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207V00000X , with the licence number:  35-090844 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207V00000X , with the licence number: 41704 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207VC0200X , with the licence number: 41704 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207VC0200X , with the licence number: 35-090844 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207VM0101X , with the licence number: 35-090844 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207VM0101X , with the licence number: 35090844 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207VM0101X , with the licence number: 41704 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 200068320A , issued by the state of ( OK ) . This identifiers is of the category "MEDICAID".
  • Identifier: 2798549 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 32075375 , issued by the state of ( NM ) . This identifiers is of the category "MEDICAID".
  • Identifier: 164050001 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".