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Individual

MR. CARLETON J WOOD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
OD

Contact information

Practice address
101 SOUTH MAIN ST., CHAPMANVILLE, WV 25508
(304) 855-3535
(304) 855-3535
Mailing address
PO BOX 1630, CHAPMANVILLE, WV 25508
(304) 855-3535
(304) 855-3535

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
742-0
WV
152W00000X
Optometrist
7420
WV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000537408
BC BS
WV
05
0150711000
WV
01
410001206
RAILROAD MEDICARE
WV
Enumeration date
08/21/2006
Last updated
11/12/2008
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