Healthcare Provider Details

I. General information

NPI: 1497563134
Provider Name (Legal Business Name): TRAVIS HOOD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/27/2024
Last Update Date: 12/27/2024
Certification Date: 12/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1268 ELECTRIC AVE
SPRINGDALE AR
72764-7498
US

IV. Provider business mailing address

3127 SOUTHWEST DR
JONESBORO AR
72404-8404
US

V. Phone/Fax

Practice location:
  • Phone: 479-750-1500
  • Fax:
Mailing address:
  • Phone: 870-219-9740
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code373H00000X
TaxonomyDay Training/Habilitation Specialist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: