Provider Demographics
NPI:1801344825
Name:HOOD, IAN CLARK (MB, CHB,)
Entity type:Individual
Prefix:DR
First Name:IAN
Middle Name:CLARK
Last Name:HOOD
Suffix:
Gender:M
Credentials:MB, CHB,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2040 2ND ST
Mailing Address - Street 2:
Mailing Address - City:DELANCO
Mailing Address - State:NJ
Mailing Address - Zip Code:08075-4952
Mailing Address - Country:US
Mailing Address - Phone:856-255-5761
Mailing Address - Fax:
Practice Address - Street 1:2040 2ND ST
Practice Address - Street 2:
Practice Address - City:DELANCO
Practice Address - State:NJ
Practice Address - Zip Code:08075-4952
Practice Address - Country:US
Practice Address - Phone:856-255-5761
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-19
Last Update Date:2024-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA05867100207ZF0201X
PAMD044789E207ZF0201X
NY155358207ZF0201X
MI47161207ZF0201X
CAA41334207ZF0201X
TXJ0530207ZF0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZF0201XAllopathic & Osteopathic PhysiciansPathologyForensic Pathology