Provider Demographics
NPI:1013985142
Name:WOOD, JOHN E (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:E
Last Name:WOOD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:400 E 3RD ST
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55805-1951
Mailing Address - Country:US
Mailing Address - Phone:218-723-1112
Mailing Address - Fax:218-529-9120
Practice Address - Street 1:330 N 8TH AVE E
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:MN
Practice Address - Zip Code:55805-2024
Practice Address - Country:US
Practice Address - Phone:218-723-1112
Practice Address - Fax:218-529-9120
Is Sole Proprietor?:No
Enumeration Date:2006-03-14
Last Update Date:2016-07-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MN32794174400000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN1013985142OtherBCBS
MNP01132386OtherRR MEDICARE
MN1013985142OtherWEA TRUST
WI1013985142Medicaid
1013985142OtherSECURITY HEALTH
MN1013985142OtherPREFERRED ONE
MN1013985142OtherHUMANA
MN1013985142OtherHEALTHPARTNERS
1013985142OtherWEA
MN00010049222OtherMEDICA
MN1013985142OtherUCARE
1013985142OtherTRICARE/TRIWEST
MN1013985142Medicaid
MN00010049222OtherMEDICA
MN1013985142OtherUCARE