Provider Demographics
NPI:1093754897
Name:WOOD, JAMES R (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:R
Last Name:WOOD
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2300 S CLEAR CREEK RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:KILLEEN
Mailing Address - State:TX
Mailing Address - Zip Code:76549-4984
Mailing Address - Country:US
Mailing Address - Phone:855-963-4325
Mailing Address - Fax:855-963-4325
Practice Address - Street 1:2300 S CLEAR CREEK RD
Practice Address - Street 2:SUITE 101
Practice Address - City:KILLEEN
Practice Address - State:TX
Practice Address - Zip Code:76549-4984
Practice Address - Country:US
Practice Address - Phone:855-963-4325
Practice Address - Fax:855-963-4325
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-06
Last Update Date:2014-05-16
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXG2059207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX102605604Medicaid
TX8F4360OtherBCBS
TX102605604Medicaid
TXC23741Medicare UPIN