Healthcare Provider Details

I. General information

NPI: 1871586685
Provider Name (Legal Business Name): DAVID L WOOD MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/26/2005
Last Update Date: 11/15/2024
Certification Date: 11/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8111 E THOMAS RD STE 100
SCOTTSDALE AZ
85251-5876
US

IV. Provider business mailing address

6529 N CENTRAL AVE
PHOENIX AZ
85012-1139
US

V. Phone/Fax

Practice location:
  • Phone: 480-907-7572
  • Fax:
Mailing address:
  • Phone: 602-769-3915
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number0101282370
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License Number35449
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: