Healthcare Provider Details

I. General information

NPI: 1902987910
Provider Name (Legal Business Name): ISAAC K WOOD M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/17/2006
Last Update Date: 05/06/2020
Certification Date: 05/06/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9020 STONY POINT PKWY STE 365
RICHMOND VA
23235-1947
US

IV. Provider business mailing address

9020 STONY POINT PKWY STE 365
RICHMOND VA
23235-1947
US

V. Phone/Fax

Practice location:
  • Phone: 804-763-9863
  • Fax: 804-237-0980
Mailing address:
  • Phone: 804-763-9863
  • Fax: 804-237-0980

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number0101038084
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: