MEDICARE: FRED KENNARD HOOD M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	45071	GA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
8	080140397	OTHER	GA	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	0100102	OTHER	GA	UNITED HEALTHCARE
3	10033108	OTHER	GA	AMERIGROUP
4	52728647001	OTHER	GA	BC/BS GEORGIA
5	8266	OTHER	GA	KAISER
6	1061050002	OTHER	GA	PEACHSTATE
7	314128	OTHER	GA	WELLCARE

General Provider Information

NPI Number	:	1043200884
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FRED KENNARD HOOD M.D.

Provider Business Mailing Address
First Line	:	65 OLD JACKSON RD
Second Line	:
City	:	MCDONOUGH
State	:	GA
Zip	:	30252-3095
Country	:	US
Telephone Number	:	678-490-0080
Fax Number	:	678-490-0091

Provider Business Practice Location Address
First Line	:	65 OLD JACKSON RD
Second Line	:
City	:	MCDONOUGH
State	:	GA
Zip	:	30252-3095
Country	:	US
Telephone Number	:	678-490-0080
Fax Number	:	678-490-0091

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/24/2005
Last Update Date	:	02/12/2014

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Directions to “ FRED KENNARD HOOD M.D.” Practice Location

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