Individual
BRYAN T WOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1230 E MAIN ST, MANKATO CLINIC @ MAIN STREET, MANKATO, MN 56001-5066
(507) 625-1811
Mailing address
1230 E MAIN ST, PO BOX 8674, MANKATO, MN 56001-5066
(507) 625-1811
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
43467
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
020054167
RR MEDICARE
—
01
—
027L5WO
BCBS MN
—
05
—
0593053
—
IA
01
—
1700938
MEDICA MN
—
01
—
171077
UCARE MN
—
01
—
2149398
AMERICAS PPO MN
—
01
—
410849339 56001 C198
CHAMPUS
—
05
—
988153100
—
MN
01
—
HP38121
HEALTH PARTNERS MN
—
01
—
NA2951034555
PREFERRED ONE MN
—
Enumeration date
01/10/2006
Last updated
09/02/2011
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