Basic Information
| Provider Information | |||||||||
| NPI: | 1356360689 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HOOD | ||||||||
| FirstName: | CLEVELAND | ||||||||
| MiddleName: | TED | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 117 S 2ND ST | ||||||||
| Address2: | |||||||||
| City: | AUGUSTA | ||||||||
| State: | AR | ||||||||
| PostalCode: | 720062309 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8703472534 | ||||||||
| FaxNumber: | 8703473492 | ||||||||
| Practice Location | |||||||||
| Address1: | 8 NORTH RAILROAD AVENUE | ||||||||
| Address2: | |||||||||
| City: | MAYFLOWER | ||||||||
| State: | AR | ||||||||
| PostalCode: | 721069430 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5014709780 | ||||||||
| FaxNumber: | 5014470985 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/18/2006 | ||||||||
| LastUpdateDate: | 06/17/2014 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | C-5204 | AR | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 080166162 | 01 | RR MEDICARE | OTHER | 105485001 | 05 | AR | MEDICAID |