Provider Demographics
NPI:1669535910
Name:WOOD, JOHN CLARK (DC)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:CLARK
Last Name:WOOD
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:310 CIVIC AVE
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:MD
Mailing Address - Zip Code:21804
Mailing Address - Country:US
Mailing Address - Phone:410-742-2229
Mailing Address - Fax:410-742-2235
Practice Address - Street 1:310 CIVIC AVE
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:MD
Practice Address - Zip Code:21804
Practice Address - Country:US
Practice Address - Phone:410-742-2229
Practice Address - Fax:410-742-2235
Is Sole Proprietor?:No
Enumeration Date:2006-12-18
Last Update Date:2011-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD1849PT111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD255825OtherMAMSI HEALTH PLANS
MDLU480EOtherBCBS
MD60871901OtherBCBS INDIVIDUAL
MDE6660002OtherFEDACARE BCBS BLUE CHOICE
MD60871901OtherBCBS INDIVIDUAL
MDE6660002OtherFEDACARE BCBS BLUE CHOICE