Individual
ROBERT ALLEN WOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1919 LATHROP ST, FAIRBANKS, AK 99701-5937
(907) 459-3500
Mailing address
PO BOX 73720, FAIRBANKS, AK 99707-3720
(509) 990-9640
(907) 459-3500
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA10003794
WA
363AM0700X
Medical Physician Assistant
139988
AK
363AS0400X
Surgical Physician Assistant
Primary
139988
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010017647
REGENCE BLUE SHIELD OF ID
ID
05
—
003783300
—
ID
01
—
149074
DEPT OF LABOR & INDUSTRI
WA
01
—
15388
GROUP HEALTH NW
WA
01
—
379109600
OWCP
WA
05
—
8387359
—
WA
01
—
8929877
CRIME VICTIMS
WA
01
—
970019578
RR MEDICARE
WA
01
—
KQ506
BLUE CROSS OF IDAHO
ID
01
—
WO4266
ASURIS NW HEALTH
WA
Enumeration date
03/14/2006
Last updated
12/31/2018
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