Healthcare Provider Details

I. General information

NPI: 1891781845
Provider Name (Legal Business Name): NATHAN T. WOOD MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/26/2005
Last Update Date: 09/15/2025
Certification Date: 09/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7912 E 31ST CT STE 200
TULSA OK
74145-1334
US

IV. Provider business mailing address

601 S HARBOUR ISLAND BLVD STE 200
TAMPA FL
33602-5925
US

V. Phone/Fax

Practice location:
  • Phone: 918-743-8200
  • Fax: 918-743-8609
Mailing address:
  • Phone: 727-322-3439
  • Fax: 800-928-7449

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number20374
License Number StateOK
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberL5186
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: