Individual
CHARLES E WOOD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1301 PALM AVE STE 600, JACKSONVILLE, FL 32207-8432
(904) 202-7300
(904) 202-7433
Mailing address
PO BOX 746654, ATLANTA, GA 30374-6654
(904) 202-2092
(904) 393-7603
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA2616
FL
363AS0400X
Surgical Physician Assistant
PA2616
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
290017300
—
FL
01
—
970009795
RAILROAD MEDICARE
—
01
—
P00088264
RAILROAD MEDICARE
—
Enumeration date
04/14/2006
Last updated
03/26/2024
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