Provider Demographics
NPI:1487855813
Name:JEFF M. HOOD MD PC
Entity Type:Organization
Organization Name:JEFF M. HOOD MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFF
Authorized Official - Middle Name:M
Authorized Official - Last Name:HOOD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:580-235-0158
Mailing Address - Street 1:PO BOX 807
Mailing Address - Street 2:
Mailing Address - City:ADA
Mailing Address - State:OK
Mailing Address - Zip Code:74821-0807
Mailing Address - Country:US
Mailing Address - Phone:580-235-0158
Mailing Address - Fax:580-421-9512
Practice Address - Street 1:430 N MONTE VISTA ST
Practice Address - Street 2:
Practice Address - City:ADA
Practice Address - State:OK
Practice Address - Zip Code:74820-4610
Practice Address - Country:US
Practice Address - Phone:580-421-1160
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-31
Last Update Date:2007-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK19894207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK19894OtherSTATE LICENSE NUMBER
OKG93101Medicare UPIN