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General NPI Number Information
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NPI Number | 1104440619
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Entity Type | Individual
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Provider Name | KAITLIN ELIZABETH WOOD PA-C
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Gender | Female
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Dates
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Enumeration Date | 05/31/2020
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Last Update Date | 07/18/2025
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Provider Practice Location Address
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Address Line | 2900 S TELEPHONE RD STE 250
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City | MOORE
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State | OK
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Zip | 73160-2969
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Country | US
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Telephone | 405-237-7500
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Fax | 405-237-7512
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Provider Business Mailing Address
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Address Line | 2900 S TELEPHONE RD STE 250
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City | MOORE
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State | OK
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Zip | 73160-2969
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Country | US
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Telephone | 405-237-7500
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA.0006692
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License Number State | CO
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