Provider Demographics
NPI:1508898883
Name:WOOD, JEFFREY W (DC FIACA)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:W
Last Name:WOOD
Suffix:
Gender:M
Credentials:DC FIACA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:426 N A ST
Mailing Address - Street 2:
Mailing Address - City:ARKANSAS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:67005-2208
Mailing Address - Country:US
Mailing Address - Phone:620-442-8900
Mailing Address - Fax:620-442-8927
Practice Address - Street 1:426 N A ST
Practice Address - Street 2:
Practice Address - City:ARKANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:67005-2208
Practice Address - Country:US
Practice Address - Phone:620-442-8900
Practice Address - Fax:620-442-8927
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-07
Last Update Date:2019-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS01-04065111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS660023OtherMEDICARE/ PTAN/ BCBS
KSDA1482OtherRAILROAD MEDICARE
KS060917OtherKS BCBS
KS226490OtherCOVENTRY INSURANCE
KS2122OtherPREFERRED PLUS
KS2122OtherPREFERRED PLUS
KS660023Medicare ID - Type Unspecified
KS226490OtherCOVENTRY INSURANCE