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General NPI Number Information
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NPI Number | 1003999483
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Entity Type | Individual
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Provider Name | WILLIAM JONATHAN WOOD MD
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Gender | Male
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Dates
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Enumeration Date | 10/23/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2643 N 113TH ST
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City | WAUWATOSA
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State | WI
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Zip | 53226-1216
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Country | US
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Telephone | 414-526-9683
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Fax |
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Provider Business Mailing Address
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Address Line | 2643 N 113TH ST
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City | WAUWATOSA
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State | WI
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Zip | 53226-1216
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Country | US
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Telephone | 414-526-9683
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 47252020
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License Number State | WI
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