MEDICARE: MICHAEL CLARK WOOD FNP

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	363LF0000X	Family Nurse Practitioner	AP8470	AZ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1477900678
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL CLARK WOOD FNP

Provider Business Mailing Address
First Line	:	261 N ROOSEVELT AVE
Second Line	:
City	:	CHANDLER
State	:	AZ
Zip	:	85226-2617
Country	:	US
Telephone Number	:	480-677-8282
Fax Number	:	888-316-1686

Provider Business Practice Location Address
First Line	:	287 E HUNT HWY STE 105
Second Line	:
City	:	SAN TAN VALLEY
State	:	AZ
Zip	:	85143-5096
Country	:	US
Telephone Number	:	480-677-8282
Fax Number	:	888-316-1686

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

Provider Enumeration Date	:	05/17/2016
Last Update Date	:	12/12/2025

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