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General NPI Number Information
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NPI Number | 1366606394
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Entity Type | Individual
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Provider Name | STUART THOMAS WOOD M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/18/2008
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Last Update Date | 01/16/2020
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Provider Practice Location Address
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Address Line | 301 FISHER ST
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City | KEESLER AFB
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State | MS
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Zip | 39534-2508
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Country | US
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Telephone | 228-376-3551
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Fax |
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Provider Business Mailing Address
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Address Line | 301 FISHER ST
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City | KEESLER AFB
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State | MS
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Zip | 39534-2508
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Country | US
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Telephone | 228-376-3551
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 0101247658
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number | 0101247658
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License Number State | VA
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Taxonomy #3
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Taxonomy Code | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number | 26741
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License Number State | MS
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