Basic Information
| Provider Information | |||||||||
| NPI: | 1104956655 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ROGER W HOOD MD PA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 12200 W 106TH ST STE 400 | ||||||||
| Address2: | |||||||||
| City: | OVERLAND PARK | ||||||||
| State: | KS | ||||||||
| PostalCode: | 662152305 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9138942121 | ||||||||
| FaxNumber: | 9138949592 | ||||||||
| Practice Location | |||||||||
| Address1: | 12200 W 106TH ST STE 400 | ||||||||
| Address2: | |||||||||
| City: | OVERLAND PARK | ||||||||
| State: | KS | ||||||||
| PostalCode: | 662152305 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9138942121 | ||||||||
| FaxNumber: | 9138949592 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/06/2007 | ||||||||
| LastUpdateDate: | 12/18/2007 | ||||||||
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| AuthorizedOfficialLastName: | SWARTS | ||||||||
| AuthorizedOfficialFirstName: | JAN | ||||||||
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| AuthorizedOfficialTitleorPosition: | OFFICE MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 9134020059 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MS. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207X00000X | 01-20021 | KS | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Orthopaedic Surgery |
ID Information
| ID | Type | State | Issuer | Description | 1528072782 | 01 | KS | NPI | OTHER | DG2850 | 01 | KS | MEDICARE RAILROAD GROUP | OTHER |