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General NPI Number Information
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NPI Number | 1588834931
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Entity Type | Organization
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Legal Business Name | AVERY WOOD MD LLC
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Dates
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Enumeration Date | 03/01/2008
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 10 BANK STREET
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City | NORTH BENNINGTON
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State | VT
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Zip | 05257
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Country | US
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Telephone | 888-421-6801
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Fax | 888-421-6801
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Provider Business Mailing Address
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Address Line | PO BOX 726
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City | NORTH BENNINGTON
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State | VT
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Zip | 05257-0726
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Country | US
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Telephone | 888-421-6801
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Fax | 888-421-6801
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Authorized Official
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Title or Position | OWNER
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Name | DR. AVERY WOOD
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Credential | M.D.
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Telephone | 888-421-6801
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | 430F01
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License Number State | VT
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