Organization
WOOD MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAVON JENEEN WOOD MD (PRESIDEN)
(479) 219-5008
Entity
Organization
Contact information
Practice address
1605 W MAIN ST, RUSSELLVILLE, AR 72801-2719
(479) 219-5008
(479) 219-5028
Mailing address
1605 W MAIN ST, RUSSELLVILLE, AR 72801-2719
(479) 219-5008
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
08/03/2017
Last updated
07/25/2022
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