Provider Demographics
NPI:1235243114
Name:WOOD, WILLIAM A JR (MD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:A
Last Name:WOOD
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:860 OMNI BLVD
Mailing Address - Street 2:SUITE 303
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23606-4430
Mailing Address - Country:US
Mailing Address - Phone:757-232-8769
Mailing Address - Fax:757-232-8769
Practice Address - Street 1:860 OMNI BLVD
Practice Address - Street 2:SUITE 102
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23606-4430
Practice Address - Country:US
Practice Address - Phone:757-873-1935
Practice Address - Fax:757-223-7760
Is Sole Proprietor?:No
Enumeration Date:2006-08-18
Last Update Date:2012-04-12
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Provider Licenses
StateLicense IDTaxonomies
VA01010343572085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAP00093212OtherRR MEDICARE
VA010058970Medicaid
E11664Medicare UPIN
VA010058970Medicaid