Provider Demographics
NPI:1922627702
Name:WOOD, HARRISON (DO)
Entity Type:Individual
Prefix:
First Name:HARRISON
Middle Name:
Last Name:WOOD
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:255 SUGAR MAPLE LN
Mailing Address - Street 2:
Mailing Address - City:ONTARIO
Mailing Address - State:OH
Mailing Address - Zip Code:44903-6602
Mailing Address - Country:US
Mailing Address - Phone:419-631-2075
Mailing Address - Fax:
Practice Address - Street 1:SUMMA HEALTH CRITICAL CARE MEDICINE FELLOWSHIP
Practice Address - Street 2:525 EAST MARKET STREET
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44309
Practice Address - Country:US
Practice Address - Phone:330-379-5083
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-13
Last Update Date:2023-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
OH34.015902390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program