Healthcare Provider Details

I. General information

NPI: 1336234046
Provider Name (Legal Business Name): ARTHUR PAUL WOOD M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/04/2006
Last Update Date: 10/18/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11402 ANDERSON RD SUITE D
GREENVILLE SC
29611-7557
US

IV. Provider business mailing address

1 INDEPENDENCE PT STE 212
GREENVILLE SC
29615-4536
US

V. Phone/Fax

Practice location:
  • Phone: 864-631-2799
  • Fax: 864-631-2795
Mailing address:
  • Phone: 864-797-6174
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207YX0905X
TaxonomyOtolaryngology/Facial Plastic Surgery Physician
License Number33076
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: