Provider Demographics
NPI:1073553913
Name:WOOD, JOHN S (PA-C)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:S
Last Name:WOOD
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:129 MCDOWELL ST
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28801-4434
Mailing Address - Country:US
Mailing Address - Phone:828-258-8800
Mailing Address - Fax:828-281-7178
Practice Address - Street 1:75B LIVINGSTON ST
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28801-4353
Practice Address - Country:US
Practice Address - Phone:828-258-8800
Practice Address - Fax:828-281-7178
Is Sole Proprietor?:No
Enumeration Date:2006-06-08
Last Update Date:2008-01-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCP36031Medicare UPIN
NC2764117Medicare PIN