Provider Demographics
NPI:1063442564
Name:WOOD, JOSEPH PAUL (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:PAUL
Last Name:WOOD
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2900 LEMAY FERRY RD
Mailing Address - Street 2:SUITE 208
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63125-3900
Mailing Address - Country:US
Mailing Address - Phone:314-543-5984
Mailing Address - Fax:314-543-5299
Practice Address - Street 1:2900 LEMAY FERRY RD
Practice Address - Street 2:SUITE 208
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63125-3900
Practice Address - Country:US
Practice Address - Phone:314-543-5984
Practice Address - Fax:314-543-5299
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2010-03-31
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MOR8B87207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO331975681Medicare PIN
MOA13429Medicare UPIN