Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YX0905X | Otolaryngology/Facial Plastic Surgery | 34003193 | OH |
NPI | 1811982085 |
---|---|
Provider Name | Clifton R Hood IV |
First Address | Bellefontaine, OH 43311-2855 |
Second Address | Bellefontaine, OH 43311-2855 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/09/2005 |
Last Update Date | 02/02/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0466562 | (05) | OH |
C02231 | (02) |