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General NPI Number Information
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NPI Number | 1306857149
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Entity Type | Individual
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Provider Name | PAUL DAVID WOOD PA-C
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Gender | Male
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Dates
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Enumeration Date | 08/10/2006
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Last Update Date | 01/23/2012
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Provider Practice Location Address
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Address Line | 716 E MANITOBA AVE
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City | ELLENSBURG
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State | WA
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Zip | 98926-3842
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Country | US
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Telephone | 509-925-3151
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Fax | 509-925-4382
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Provider Business Mailing Address
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Address Line | PO BOX 728
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City | STIGLER
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State | OK
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Zip | 74462-0728
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Country | US
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Telephone | 918-967-8814
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Fax | 918-967-8894
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 1476
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License Number State | OK
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