Individual
KELLY ANN WOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
420 COLUMBIA CTR, COLUMBIA, IL 62236-2540
(618) 791-2011
(618) 417-6046
Mailing address
420 COLUMBIA CTR, COLUMBIA, IL 62236-2540
(618) 719-2011
(618) 417-6046
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036123456
IL
207Q00000X
Family Medicine Physician
146940
IL
207QB0002X
Obesity Medicine (Family Medicine) Physician
89988457
IL
Other
Enumeration date
04/17/2007
Last updated
10/17/2024
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