MEDICARE: DAVID L WOOD MD

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	2085R0202X	Diagnostic Radiology Physician	0101282370	VA
2	2085R0204X	Vascular & Interventional Radiology Physician	35449	AZ

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	Z214287	OTHER	AZ	MEDICARE PTAN
7	P00131105	OTHER		PGBA (RR MEDICARE)

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	138582	OTHER	VT	ANTHEM
4	4085050	OTHER	TN	BCBS
5	R06903	OTHER	TN	JOHN DEERE
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
8	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
9	Z148084	OTHER	AZ	PTAN

General Provider Information

NPI Number	:	1871586685
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID L WOOD MD

Provider Business Mailing Address
First Line	:	6529 N CENTRAL AVE
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85012-1139
Country	:	US
Telephone Number	:	602-769-3915
Fax Number	:

Provider Business Practice Location Address
First Line	:	8111 E THOMAS RD STE 100
Second Line	:
City	:	SCOTTSDALE
State	:	AZ
Zip	:	85251-5876
Country	:	US
Telephone Number	:	480-907-7572
Fax Number	:

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

Provider Enumeration Date	:	08/26/2005
Last Update Date	:	11/15/2024

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Directions to “ DAVID L WOOD MD” Practice Location

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