Provider Demographics
NPI:1386932333
Name:HOOD, MICHAEL PHILIP (MD)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:PHILIP
Last Name:HOOD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2492
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73083-2492
Mailing Address - Country:US
Mailing Address - Phone:405-607-6699
Mailing Address - Fax:
Practice Address - Street 1:1851 S KELLY AVE STE A
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73013-3929
Practice Address - Country:US
Practice Address - Phone:405-607-6699
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-12
Last Update Date:2024-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN52493207WX0107X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200814060AMedicaid