MEDICARE: DR. W. SCOTT WOOD III PH.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	231H00000X	Audiologist	A-0014	WV

General Provider Information

NPI Number	:	1104805027
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. W. SCOTT WOOD III PH.D.

Provider Business Mailing Address
First Line	:	47 CAMBRIDGE CT
Second Line	:
City	:	MARTINSBURG
State	:	WV
Zip	:	25401-0951
Country	:	US
Telephone Number	:	304-263-8443
Fax Number	:

Provider Business Practice Location Address
First Line	:	510 BUTLER AVE
Second Line	:	DIVISION OF REHABILITATION SERVICES (117)
City	:	MARTINSBURG
State	:	WV
Zip	:	25401-9990
Country	:	US
Telephone Number	:	304-263-0811
Fax Number	:	304-262-4842

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

Provider Enumeration Date	:	01/10/2006
Last Update Date	:	07/08/2007

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