Basic Information
| Provider Information | |||||||||
| NPI: | 1861783060 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HOOD | ||||||||
| FirstName: | KENNETH | ||||||||
| MiddleName: | ANDREW | ||||||||
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| Credential: | DO | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1325 N LITCHFIELD RD STE 125 | ||||||||
| Address2: | |||||||||
| City: | GOODYEAR | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 853951228 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6238829161 | ||||||||
| FaxNumber: | 6239250745 | ||||||||
| Practice Location | |||||||||
| Address1: | 1325 N LITCHFIELD RD STE 125 | ||||||||
| Address2: | |||||||||
| City: | GOODYEAR | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 853951228 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6232421231 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/22/2011 | ||||||||
| LastUpdateDate: | 08/04/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207X00000X | 006711 | AZ | Y | Allopathic & Osteopathic Physicians | Orthopaedic Surgery |
No ID Information.