Individual
MR. ERIC R WOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1500 JAMES SIMPSON JR WAY, COVINGTON, KY 41011-0801
(859) 655-1100
(859) 655-1102
Mailing address
PO BOX 635283, CINCINNATI, OH 45263-5283
(859) 344-5555
(859) 344-5552
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA1045
KY
363AM0700X
Medical Physician Assistant
PA1045
KY
363AS0400X
Surgical Physician Assistant
PA1045
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100056850
—
KY
05
—
9500517900
—
KY
01
—
P00424232
RAILROAD MEDICARE
—
01
—
WOPA24344
OH MEDICARE
OH
Enumeration date
07/07/2006
Last updated
02/28/2023
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