Provider Demographics
NPI:1265646541
Name:HOOD, ELLIE EARLES (MD)
Entity Type:Individual
Prefix:
First Name:ELLIE
Middle Name:EARLES
Last Name:HOOD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2585 3RD AVE
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:WV
Mailing Address - Zip Code:25703-1642
Mailing Address - Country:US
Mailing Address - Phone:304-697-1396
Mailing Address - Fax:304-697-2086
Practice Address - Street 1:1630 13TH AVE
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:WV
Practice Address - Zip Code:25701-3812
Practice Address - Country:US
Practice Address - Phone:304-697-2014
Practice Address - Fax:304-697-2017
Is Sole Proprietor?:No
Enumeration Date:2007-05-09
Last Update Date:2020-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV23466207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2947182Medicaid
WV3810014410Medicaid
KY7100079090Medicaid
WV3810014410Medicaid
OH2947182Medicaid
WV4261801Medicare PIN
KY7100079090Medicaid