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Individual

DR. HENRY EDWARD WOOD JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
745 OLIVE ST, STE 200, SHREVEPORT, LA 71104-2246
(318) 226-0809
(318) 226-0812
Mailing address
745 OLIVE ST, STE 200, SHREVEPORT, LA 71104-2246
(318) 226-0809
(318) 226-0812

Taxonomy

Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
15619
LA
207RN0300X
Nephrology Physician
9905
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1949442
LA
Enumeration date
08/15/2005
Last updated
07/08/2007
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