Provider Demographics
NPI:1275762320
Name:WOOD, ARTHUR EUGENE IV (MD)
Entity Type:Individual
Prefix:DR
First Name:ARTHUR
Middle Name:EUGENE
Last Name:WOOD
Suffix:IV
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:920 MATTHEW DR STE D
Mailing Address - Street 2:
Mailing Address - City:WAYNESBORO
Mailing Address - State:MS
Mailing Address - Zip Code:39367-2553
Mailing Address - Country:US
Mailing Address - Phone:601-735-3918
Mailing Address - Fax:601-735-4227
Practice Address - Street 1:920 MATTHEW DR STE D
Practice Address - Street 2:
Practice Address - City:WAYNESBORO
Practice Address - State:MS
Practice Address - Zip Code:39367-2553
Practice Address - Country:US
Practice Address - Phone:601-735-3918
Practice Address - Fax:601-735-4227
Is Sole Proprietor?:No
Enumeration Date:2009-07-10
Last Update Date:2012-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS21319207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS05487548Medicaid
MS05487548Medicaid