MEDICARE: DR. AMBER NICHOLE 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	2084P0800X	Psychiatry Physician	55824	KY
2	2084P0804X	Child & Adolescent Psychiatry Physician	55824	KY

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	:	1750878039
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AMBER NICHOLE WOOD M.D.

Provider Business Mailing Address
First Line	:	5200 COMMERCE CROSSING
Second Line	:	THRID FLOOR
City	:	LOUISVILLE
State	:	KY
Zip	:	40229
Country	:	US
Telephone Number	:	502-253-4924
Fax Number	:	502-489-5750

Provider Business Practice Location Address
First Line	:	2530 SIR BARTON WAY STE 125
Second Line	:
City	:	LEXINGTON
State	:	KY
Zip	:	40509-2746
Country	:	US
Telephone Number	:	718-859-6390
Fax Number	:	859-639-0051

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

Provider Enumeration Date	:	04/22/2018
Last Update Date	:	08/24/2023

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