Provider Demographics
NPI:1023207701
Name:WOOD EYECARE, P.C.
Entity Type:Organization
Organization Name:WOOD EYECARE, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:WOOD
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:770-978-2990
Mailing Address - Street 1:3050 FIVE FORKS TRICKUM RD SW
Mailing Address - Street 2:SUITE 112
Mailing Address - City:LILBURN
Mailing Address - State:GA
Mailing Address - Zip Code:30047-1807
Mailing Address - Country:US
Mailing Address - Phone:770-978-2990
Mailing Address - Fax:
Practice Address - Street 1:3050 FIVE FORKS TRICKUM RD SW
Practice Address - Street 2:SUITE 112
Practice Address - City:LILBURN
Practice Address - State:GA
Practice Address - Zip Code:30047-1807
Practice Address - Country:US
Practice Address - Phone:770-978-2990
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-18
Last Update Date:2024-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA1148-T261QS0132X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS0132XAmbulatory Health Care FacilitiesClinic/CenterOphthalmologic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA41ZCCGKMedicare UPIN