Provider Demographics
NPI:1639862022
Name:WOOD, DENNIS HERSHEL
Entity Type:Individual
Prefix:
First Name:DENNIS
Middle Name:HERSHEL
Last Name:WOOD
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2560 OLD COUNTY RD
Mailing Address - Street 2:
Mailing Address - City:POCAHONTAS
Mailing Address - State:AR
Mailing Address - Zip Code:72455-4118
Mailing Address - Country:US
Mailing Address - Phone:870-972-4000
Mailing Address - Fax:870-892-0930
Practice Address - Street 1:2560 OLD COUNTY RD
Practice Address - Street 2:
Practice Address - City:POCAHONTAS
Practice Address - State:AR
Practice Address - Zip Code:72455-4118
Practice Address - Country:US
Practice Address - Phone:870-972-4000
Practice Address - Fax:870-892-0930
Is Sole Proprietor?:No
Enumeration Date:2023-05-31
Last Update Date:2023-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator