Healthcare Provider Details

I. General information

NPI: 1972894996
Provider Name (Legal Business Name): AURELIA C.H. WOOD M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: AURELIA CHRISTINE HOLLAND M.D.

II. Dates (important events)

Enumeration Date: 04/25/2011
Last Update Date: 01/24/2025
Certification Date: 01/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

411 E CHESTNUT ST # STREET7
LOUISVILLE KY
40202-1713
US

IV. Provider business mailing address

PO BOX 776879
CHICAGO IL
60677-6879
US

V. Phone/Fax

Practice location:
  • Phone: 502-588-3400
  • Fax:
Mailing address:
  • Phone: 502-559-9425
  • Fax: 502-272-5339

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2080P0205X
TaxonomyPediatric Endocrinology Physician
License Number35-133249
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code2080P0205X
TaxonomyPediatric Endocrinology Physician
License Number47360
License Number StateKY
# 3
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number47360
License Number StateKY
# 4
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number35-133249
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: