Provider Demographics
NPI:1356360689
Name:HOOD, CLEVELAND TED (MD)
Entity type:Individual
Prefix:DR
First Name:CLEVELAND
Middle Name:TED
Last Name:HOOD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:117 S 2ND ST
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:AR
Mailing Address - Zip Code:72006-2309
Mailing Address - Country:US
Mailing Address - Phone:870-347-2534
Mailing Address - Fax:870-347-3492
Practice Address - Street 1:8 NORTH RAILROAD AVENUE
Practice Address - Street 2:
Practice Address - City:MAYFLOWER
Practice Address - State:AR
Practice Address - Zip Code:72106-9430
Practice Address - Country:US
Practice Address - Phone:501-470-9780
Practice Address - Fax:501-447-0985
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2014-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARC-5204207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
080166162OtherRR MEDICARE
AR105485001Medicaid
AR52473Medicare ID - Type Unspecified
AR105485001Medicaid
D84162Medicare UPIN