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Individual
JACOB MYLES WOOD
Active
Individual
JACOB MYLES WOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
00024312
AL
207Q00000X
Family Medicine Physician
Primary
202160
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
051522945
—
AL
05
—
1319368
—
LA
05
—
1328201
—
LA
05
—
1347957
—
LA
01
—
51522945
BLUE CROSS BLUE SHIELD
AL
01
—
H51432
VIVA HEALTH
AL
01
—
P00141370
RAIL ROAD MEDICARE
—
Enumeration date
02/07/2006
Last updated
12/13/2018
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