Individual
MRS. ELIZABETH COPELAN WOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
898 COLLEGE ST, MONTICELLO, GA 31064-1258
(706) 468-4519
(706) 468-6631
Mailing address
898 COLLEGE ST, MONTICELLO, GA 31064-1258
(706) 468-4519
(706) 468-6631
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
363AM0700X
Medical Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7733
GA STATE LICENSE
GA
Enumeration date
09/18/2010
Last updated
06/22/2021
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