Provider Demographics
NPI:1427044221
Name:HOOD, RODERICK WILLIAM (PA-C)
Entity Type:Individual
Prefix:MR
First Name:RODERICK
Middle Name:WILLIAM
Last Name:HOOD
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:715 S BEELINE HWY
Mailing Address - Street 2:
Mailing Address - City:PAYSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85541-5320
Mailing Address - Country:US
Mailing Address - Phone:928-468-6607
Mailing Address - Fax:928-468-6025
Practice Address - Street 1:715 S BEELINE HWY
Practice Address - Street 2:
Practice Address - City:PAYSON
Practice Address - State:AZ
Practice Address - Zip Code:85541-5320
Practice Address - Country:US
Practice Address - Phone:928-468-6607
Practice Address - Fax:928-468-6025
Is Sole Proprietor?:No
Enumeration Date:2005-09-27
Last Update Date:2023-10-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ1308363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ67087Medicare ID - Type Unspecified
S64563Medicare UPIN