Individual
JASON GERALD HOOTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2100 PROVIDENCE WAY, IDAHO FALLS, ID 83404
(208) 529-6600
(208) 529-6602
Mailing address
2100 PROVIDENCE WAY, IDAHO FALLS, ID 83404-4951
(208) 529-6600
(208) 529-6602
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
4301111952
MI
207WX0120X
Cornea and External Diseases Specialist Physician
Primary
M-14241
ID
390200000X
Student in an Organized Health Care Education/Training Program
RS2016-0104
NM
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
05/01/2013
Last updated
11/05/2020
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