Provider Demographics
NPI:1891861449
Name:WOOD, SARAH EMILEE (DO)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:EMILEE
Last Name:WOOD
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:EMILEE
Other - Last Name:SANDERS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DO
Mailing Address - Street 1:PO BOX 306
Mailing Address - Street 2:136 W FOLEY
Mailing Address - City:EUFAULA
Mailing Address - State:OK
Mailing Address - Zip Code:74432
Mailing Address - Country:US
Mailing Address - Phone:918-618-4000
Mailing Address - Fax:918-473-1148
Practice Address - Street 1:615 S BROADWAY
Practice Address - Street 2:
Practice Address - City:CHECOTAH
Practice Address - State:OK
Practice Address - Zip Code:74426
Practice Address - Country:US
Practice Address - Phone:918-473-1148
Practice Address - Fax:918-473-0250
Is Sole Proprietor?:No
Enumeration Date:2006-11-27
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3217207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100206420GMedicaid
OK100206420FMedicaid
OK100206420HMedicaid
900522244Medicare ID - Type UnspecifiedGROUP
OK100206420FMedicaid
OK100206420HMedicaid