Provider Demographics
NPI:1518973767
Name:HOOD, ROBERT SIDNEY (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:SIDNEY
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 1:24 S 1100 E
Mailing Address - Street 2:SUITE 302
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84102-1500
Mailing Address - Country:US
Mailing Address - Phone:801-531-7806
Mailing Address - Fax:801-355-5566
Practice Address - Street 1:24 S 1100 E
Practice Address - Street 2:SUITE 302
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84102-1500
Practice Address - Country:US
Practice Address - Phone:801-531-7806
Practice Address - Fax:801-355-5566
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-31
Last Update Date:2007-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT157688-1205174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT000001487Medicare PIN
UTD07406Medicare UPIN