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Individual

DR. JERRY D WOOD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
219 EASTWOOD ST, LIVINGSTON, TX 77351-3342
(936) 327-7147
(936) 327-6234
Mailing address
219 EASTWOOD ST, LIVINGSTON, TX 77351-3342
(936) 327-7147
(936) 327-6234

Taxonomy

Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
Primary
G0304
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
080005306
RAILROAD MEDICARE
TX
05
133935003
TX
01
76-0090075
FIN
TX
01
87W460
BLUECROSS BLUESHIELD
TX
Enumeration date
07/21/2005
Last updated
07/17/2008
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