Provider Demographics
NPI:1407880354
Name:HOOD, JASON A (MD)
Entity Type:Individual
Prefix:
First Name:JASON
Middle Name:A
Last Name:HOOD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:124 VERDAE BLVD.
Mailing Address - Street 2:SUITE 204
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29607
Mailing Address - Country:US
Mailing Address - Phone:864-271-9780
Mailing Address - Fax:864-271-9785
Practice Address - Street 1:124 VERDAE BLVD.
Practice Address - Street 2:SUITE 204
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29607
Practice Address - Country:US
Practice Address - Phone:864-271-9780
Practice Address - Fax:864-271-9785
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2015-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC21840207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC218400Medicaid
SCGP0135Medicaid
SC218400Medicaid
H95814Medicare UPIN