MEDICARE: DR. KAY L WOOD M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	A70825	CA
2	207VG0400X	Gynecology Physician	44888	AZ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	A70825	OTHER	CA	STATE
2	510421664	OTHER	CA	TAX ID

General Provider Information

NPI Number	:	1144264524
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KAY L WOOD M.D.

Provider Business Mailing Address
First Line	:	474 N HWY 89
Second Line	:
City	:	CHINO VALLEY
State	:	AZ
Zip	:	86323-5993
Country	:	US
Telephone Number	:	928-636-4355
Fax Number	:	928-636-0754

Provider Business Practice Location Address
First Line	:	474 N HWY 89
Second Line	:
City	:	CHINO VALLEY
State	:	AZ
Zip	:	86323-5993
Country	:	US
Telephone Number	:	928-636-4355
Fax Number	:	928-636-0754

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/15/2006
Last Update Date	:	03/07/2023

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Directions to “ DR. KAY L WOOD M.D.” Practice Location

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