Provider Demographics
NPI:1083938278
Name:DR NORMAN E WOOD JR PA
Entity Type:Organization
Organization Name:DR NORMAN E WOOD JR PA
Other - Org Name:DOCTORS URGENT CARE AND FAMILY PRACTICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SUSIE
Authorized Official - Middle Name:
Authorized Official - Last Name:THRASHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-387-7777
Mailing Address - Street 1:24441 GARRETT HWY
Mailing Address - Street 2:
Mailing Address - City:MC HENRY
Mailing Address - State:MD
Mailing Address - Zip Code:21541-1311
Mailing Address - Country:US
Mailing Address - Phone:301-387-7777
Mailing Address - Fax:301-387-7756
Practice Address - Street 1:HC 61 BOX 306
Practice Address - Street 2:
Practice Address - City:CAPON BRIDGE
Practice Address - State:WV
Practice Address - Zip Code:26711-9728
Practice Address - Country:US
Practice Address - Phone:304-856-2600
Practice Address - Fax:304-856-2604
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-17
Last Update Date:2010-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV1680261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV3810004552Medicaid