Provider Demographics
NPI:1023040581
Name:WOOD-KATZ, MELISSA A (MD)
Entity Type:Individual
Prefix:DR
First Name:MELISSA
Middle Name:A
Last Name:WOOD-KATZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 251418
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72225-1418
Mailing Address - Country:US
Mailing Address - Phone:501-364-1100
Mailing Address - Fax:
Practice Address - Street 1:7000 WELLNESS WAY STE 7230
Practice Address - Street 2:
Practice Address - City:ST SIMONS ISLAND
Practice Address - State:GA
Practice Address - Zip Code:31522-2286
Practice Address - Country:US
Practice Address - Phone:912-634-2795
Practice Address - Fax:912-638-5636
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2021-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA074624208000000X
ARE-6154208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA333473715BMedicaid
OTH000455Medicare UPIN