Healthcare Provider Details

I. General information

NPI: 1982180261
Provider Name (Legal Business Name): JOSEPH F WOOD NP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/19/2018
Last Update Date: 07/19/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12320 W BROAD ST STE 204
RICHMOND VA
23233-7606
US

IV. Provider business mailing address

8580 MAGELLAN PKWY
RICHMOND VA
23227-1149
US

V. Phone/Fax

Practice location:
  • Phone: 804-612-2980
  • Fax: 804-762-7102
Mailing address:
  • Phone: 804-627-5573
  • Fax: 866-449-0896

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0024176349
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: