Provider Demographics
NPI:1679738207
Name:CHARLES A WOOD, M.D., P.C
Entity Type:Organization
Organization Name:CHARLES A WOOD, M.D., P.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:A
Authorized Official - Last Name:WOOD
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:334-566-0546
Mailing Address - Street 1:1350 HIGHWAY 231 S
Mailing Address - Street 2:SUITE A
Mailing Address - City:TROY
Mailing Address - State:AL
Mailing Address - Zip Code:36081-3058
Mailing Address - Country:US
Mailing Address - Phone:334-566-0546
Mailing Address - Fax:334-566-3768
Practice Address - Street 1:1350 HIGHWAY 231 S
Practice Address - Street 2:SUITE A
Practice Address - City:TROY
Practice Address - State:AL
Practice Address - Zip Code:36081-3058
Practice Address - Country:US
Practice Address - Phone:334-566-0546
Practice Address - Fax:334-566-3768
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-23
Last Update Date:2008-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL22881305R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization