Provider Demographics
NPI:1114330420
Name:WOOD, AMANDA MARIE FERGUSON (MD)
Entity Type:Individual
Prefix:DR
First Name:AMANDA
Middle Name:MARIE FERGUSON
Last Name:WOOD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:AMANDA
Other - Middle Name:MARIE
Other - Last Name:FERGUSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2708 S RIFE MEDICAL LN
Mailing Address - Street 2:
Mailing Address - City:ROGERS
Mailing Address - State:AR
Mailing Address - Zip Code:72758-1452
Mailing Address - Country:US
Mailing Address - Phone:479-338-5555
Mailing Address - Fax:479-338-5533
Practice Address - Street 1:2708 S RIFE MEDICAL LN
Practice Address - Street 2:
Practice Address - City:ROGERS
Practice Address - State:AR
Practice Address - Zip Code:72758-1452
Practice Address - Country:US
Practice Address - Phone:479-338-5555
Practice Address - Fax:479-338-5533
Is Sole Proprietor?:No
Enumeration Date:2014-06-04
Last Update Date:2023-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXBP10051109207Q00000X
TXR0161207Q00000X
TN56184207Q00000X
ARE-11491207VX0000X, 208000000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetrics
No208000000XAllopathic & Osteopathic PhysiciansPediatrics