Healthcare Provider Details

I. General information

NPI: 1225291487
Provider Name (Legal Business Name): BENJAMIN G WOODS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/08/2008
Last Update Date: 01/12/2026
Certification Date: 01/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12033 AGENCY RD
PARKER AZ
85344-7718
US

IV. Provider business mailing address

PO BOX 95461
CLEVELAND OH
44101-0033
US

V. Phone/Fax

Practice location:
  • Phone: 928-669-2137
  • Fax: 928-669-3131
Mailing address:
  • Phone: 928-669-2137
  • Fax: 928-669-3131

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number39118
License Number StateIA
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberR-8669
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: