Healthcare Provider Details

I. General information

NPI: 1285785931
Provider Name (Legal Business Name): DUKE J WOOD DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/16/2007
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

605 2ND AVE N
COLUMBUS MS
39701-4513
US

IV. Provider business mailing address

48 MEDICAL PARK DR E STE 453
BIRMINGHAM AL
35235-3472
US

V. Phone/Fax

Practice location:
  • Phone: 662-434-4210
  • Fax: 662-657-1044
Mailing address:
  • Phone: 205-208-9312
  • Fax: 205-848-2227

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number17624
License Number StateMS
# 2
Primary TaxonomyY
Taxonomy Code207QA0401X
TaxonomyAddiction Medicine (Family Medicine) Physician
License Number17624
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: