Provider Demographics
NPI:1811982085
Name:HOOD, CLIFTON R IV (DO)
Entity type:Individual
Prefix:DR
First Name:CLIFTON
Middle Name:R
Last Name:HOOD
Suffix:IV
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 E PALMER RD
Mailing Address - Street 2:
Mailing Address - City:BELLEFONTAINE
Mailing Address - State:OH
Mailing Address - Zip Code:43311-2281
Mailing Address - Country:US
Mailing Address - Phone:937-592-9799
Mailing Address - Fax:937-592-9789
Practice Address - Street 1:1134 N MAIN ST
Practice Address - Street 2:SUITE 3100
Practice Address - City:BELLEFONTAINE
Practice Address - State:OH
Practice Address - Zip Code:43311-2379
Practice Address - Country:US
Practice Address - Phone:937-592-9799
Practice Address - Fax:937-592-9789
Is Sole Proprietor?:No
Enumeration Date:2005-09-14
Last Update Date:2025-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN79003207YX0905X
MT12434207Y00000X
OH34003193207YX0905X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YX0905XAllopathic & Osteopathic PhysiciansOtolaryngologyOtolaryngology/Facial Plastic Surgery
No207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0466562Medicaid
C02231Medicare UPIN
OHH214940Medicare PIN
OH4047733Medicare PIN