Basic Information
Provider Information
NPI: 1194745893
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HOOTEN
FirstName: JAMES
MiddleName: P.
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 1717
Address2:  
City: BURLINGTON
State: NC
PostalCode: 272161717
CountryCode: US
TelephoneNumber: 3365381234
FaxNumber: 3365382390
Practice Location
Address1: 1234 HUFFMAN MILL RD
Address2:  
City: BURLINGTON
State: NC
PostalCode: 272158700
CountryCode: US
TelephoneNumber: 3365381234
FaxNumber: 3365382390
Other Information
ProviderEnumerationDate: 07/19/2006
LastUpdateDate: 02/13/2013
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207X00000X0000-32942NCY Allopathic & Osteopathic PhysiciansOrthopaedic Surgery 

ID Information
IDTypeStateIssuerDescription
894446505NC MEDICAID


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