Provider Demographics
NPI:1720518020
Name:WOOD, CHRISTOPHER L
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:L
Last Name:WOOD
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3300 S OATES ST
Mailing Address - Street 2:
Mailing Address - City:DOTHAN
Mailing Address - State:AL
Mailing Address - Zip Code:36301-5694
Mailing Address - Country:US
Mailing Address - Phone:334-702-0840
Mailing Address - Fax:334-702-0580
Practice Address - Street 1:3300 S OATES ST
Practice Address - Street 2:
Practice Address - City:DOTHAN
Practice Address - State:AL
Practice Address - Zip Code:36301-5694
Practice Address - Country:US
Practice Address - Phone:334-702-0840
Practice Address - Fax:334-702-0580
Is Sole Proprietor?:No
Enumeration Date:2017-06-19
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL14590183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist