Provider Demographics
NPI:1689101404
Name:HOOD, MARY KATHERINE KATHERINE (MD)
Entity Type:Individual
Prefix:
First Name:MARY KATHERINE
Middle Name:KATHERINE
Last Name:HOOD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MARY KATHERINE
Other - Middle Name:
Other - Last Name:KERCE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2500 NORTH STATE STREET
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MS
Mailing Address - Zip Code:39216-4505
Mailing Address - Country:US
Mailing Address - Phone:601-405-4764
Mailing Address - Fax:
Practice Address - Street 1:2500 NORTH STATE STREET
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MS
Practice Address - Zip Code:39216-4504
Practice Address - Country:US
Practice Address - Phone:601-405-4764
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-11
Last Update Date:2022-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN59789208000000X
MS30107208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics