# JACOB MYLES WOOD

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1700858255
- **Gender:** Man
- **Credential:** M.D.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 00024312 | AL | — |
| 207Q00000X | Family Medicine Physician | 202160 | LA | Yes |

## Other

- **Enumeration date:** 02/07/2006
- **Last updated:** 12/13/2018

## 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 | — |