MEDICARE: AVERY WOOD MD LLC

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	261QP2300X	Primary Care Clinic/Center	430F01	VT

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	:	1588834931
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AVERY WOOD MD LLC

Provider Business Mailing Address
First Line	:	PO BOX 726
Second Line	:
City	:	NORTH BENNINGTON
State	:	VT
Zip	:	05257-0726
Country	:	US
Telephone Number	:	888-421-6801
Fax Number	:	888-421-6801

Provider Business Practice Location Address
First Line	:	10 BANK STREET
Second Line	:
City	:	NORTH BENNINGTON
State	:	VT
Zip	:	05257
Country	:	US
Telephone Number	:	888-421-6801
Fax Number	:	888-421-6801

Authorized Official
Title or Position	:	OWNER
Name	:	DR. AVERY WOOD
Credential	:	M.D.
Telephone Number	:	888-421-6801

Provider Enumeration Date	:	03/01/2008
Last Update Date	:	07/21/2022

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