Provider Demographics
NPI:1336234046
Name:WOOD, ARTHUR PAUL (MD)
Entity Type:Individual
Prefix:
First Name:ARTHUR
Middle Name:PAUL
Last Name:WOOD
Suffix:
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 1:1 INDEPENDENCE PT STE 212
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29615-4536
Mailing Address - Country:US
Mailing Address - Phone:864-797-6174
Mailing Address - Fax:
Practice Address - Street 1:11402 ANDERSON RD
Practice Address - Street 2:SUITE D
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29611-7557
Practice Address - Country:US
Practice Address - Phone:864-631-2799
Practice Address - Fax:864-631-2795
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2018-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC33076207YX0905X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YX0905XAllopathic & Osteopathic PhysiciansOtolaryngologyOtolaryngology/Facial Plastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCN30115Medicaid
SCPA5706B491Medicare PIN
WO0796493Medicare PIN
WO0796492Medicare PIN
OHWO0796491Medicare PIN