Provider Demographics
NPI:1700834512
Name:WOOD, JOHN HOWARD (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:HOWARD
Last Name:WOOD
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:316 WOODHAVEN RD
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27514-7512
Mailing Address - Country:US
Mailing Address - Phone:919-942-8701
Mailing Address - Fax:919-942-3601
Practice Address - Street 1:110 CONNER DR
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27514-7044
Practice Address - Country:US
Practice Address - Phone:919-942-8701
Practice Address - Fax:919-942-3601
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC94-00175207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8901274Medicaid
NC8901274Medicaid
NC2199689Medicare ID - Type Unspecified