Individual
JENNIFER GWEN WOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
240 SHERATON BLVD, MACON, GA 31210-1358
(478) 471-1943
(478) 475-9780
Mailing address
240 SHERATON BLVD, MACON, GA 31210-1358
(478) 471-1943
(478) 475-9780
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
005329
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
322789982B
—
GA
Enumeration date
04/04/2008
Last updated
02/09/2011
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