Provider Demographics
NPI:1356659825
Name:WOOD, ELIZABETH COPELAN (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:COPELAN
Last Name:WOOD
Suffix:
Gender:F
Credentials:PA-C
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Mailing Address - Street 1:898 COLLEGE ST
Mailing Address - Street 2:
Mailing Address - City:MONTICELLO
Mailing Address - State:GA
Mailing Address - Zip Code:31064-1258
Mailing Address - Country:US
Mailing Address - Phone:706-468-4519
Mailing Address - Fax:706-468-6631
Practice Address - Street 1:898 COLLEGE ST
Practice Address - Street 2:
Practice Address - City:MONTICELLO
Practice Address - State:GA
Practice Address - Zip Code:31064-1258
Practice Address - Country:US
Practice Address - Phone:706-468-4519
Practice Address - Fax:706-468-6631
Is Sole Proprietor?:No
Enumeration Date:2010-09-18
Last Update Date:2021-06-22
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA7733OtherGA STATE LICENSE