Provider Demographics
NPI:1710095310
Name:WOOD, WILLIAM CLEVELAND III (MD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:CLEVELAND
Last Name:WOOD
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:52 MEDICAL PARK DR E
Mailing Address - Street 2:SUITE NUMBER 308
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35235-3430
Mailing Address - Country:US
Mailing Address - Phone:205-838-3025
Mailing Address - Fax:205-838-3897
Practice Address - Street 1:52 MEDICAL PARK DR E
Practice Address - Street 2:SUITE NUMBER 308
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35235-3430
Practice Address - Country:US
Practice Address - Phone:205-838-3025
Practice Address - Fax:205-838-3897
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-25
Last Update Date:2022-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL22387208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL051509118Medicaid
AL17-10608OtherUNITED HEALTHCARE
ALC71136OtherVIVA
AL051509118OtherBLUE CROSS BLUE SHIELD
AL051509118Medicaid