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General NPI Number Information
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NPI Number | 1174513865
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Entity Type | Individual
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Provider Name | JEFFREY JON DOOD M.D.
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Gender | Male
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Dates
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Enumeration Date | 10/25/2005
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Last Update Date | 10/23/2023
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Provider Practice Location Address
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Address Line | 1005 W GREEN ST STE 301
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City | HASTINGS
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State | MI
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Zip | 49058-1729
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Country | US
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Telephone | 269-945-8080
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Fax |
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Provider Business Mailing Address
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Address Line | 100 MICHIGAN ST NE MC 845
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City | GRAND RAPIDS
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State | MI
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Zip | 49503-2560
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | JD068105
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 4301068105
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License Number State | MI
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