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NPI Code Detail

MEDICARE: MR. KURT T. WOOD PA-C

MEDICARE: MR. KURT T. WOOD PA-C
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
1363A00000XPhysician AssistantPA3194FL
2363AM0700XMedical Physician AssistantPA3194FL
3363AS0400XSurgical Physician AssistantPA3194FL

General Provider Information

NPI Number : 1780683359
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. KURT T. WOOD PA-C
Provider Business Mailing Address
First Line : 740 W PLYMOUTH AVE
Second Line :
City : DELAND
State : FL
Zip : 32720-3282
Country : US
Telephone Number : 386-734-9122
Fax Number : 386-736-4348
Provider Business Practice Location Address
First Line : 740 W PLYMOUTH AVE
Second Line :
City : DELAND
State : FL
Zip : 32720-3282
Country : US
Telephone Number : 386-734-9122
Fax Number : 386-736-4348
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/18/2005
Last Update Date : 03/03/2008

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Directions to “ MR. KURT T. WOOD PA-C” Practice Location

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