Provider Demographics
NPI:1912540576
Name:ISAAC KEITH WOOD
Entity Type:Organization
Organization Name:ISAAC KEITH WOOD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:ISAAC
Authorized Official - Middle Name:KEITH
Authorized Official - Last Name:WOOD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:804-307-8964
Mailing Address - Street 1:9020 STONY POINT PKWY STE 365
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23235-1947
Mailing Address - Country:US
Mailing Address - Phone:804-763-9863
Mailing Address - Fax:804-237-0980
Practice Address - Street 1:9020 STONY POINT PKWY STE 365
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23235-1947
Practice Address - Country:US
Practice Address - Phone:804-763-9863
Practice Address - Fax:804-237-0980
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-25
Last Update Date:2019-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent PsychiatryGroup - Single Specialty