Provider Demographics
NPI:1952582769
Name:THOMAS WOOD MD PA
Entity Type:Organization
Organization Name:THOMAS WOOD MD PA
Other - Org Name:PLANTATION MEDICAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:T
Authorized Official - Last Name:WOOD
Authorized Official - Suffix:III
Authorized Official - Credentials:MD
Authorized Official - Phone:843-837-9997
Mailing Address - Street 1:1555 FORDING ISLAND RD
Mailing Address - Street 2:SUITE C 1
Mailing Address - City:HILTON HEAD ISLAND
Mailing Address - State:SC
Mailing Address - Zip Code:29926-1175
Mailing Address - Country:US
Mailing Address - Phone:843-837-9997
Mailing Address - Fax:843-837-9998
Practice Address - Street 1:1555 FORDING ISLAND RD
Practice Address - Street 2:SUITE C 1
Practice Address - City:HILTON HEAD ISLAND
Practice Address - State:SC
Practice Address - Zip Code:29926-1175
Practice Address - Country:US
Practice Address - Phone:843-837-9997
Practice Address - Fax:843-837-9998
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-20
Last Update Date:2008-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCD092268120Medicare UPIN
SC8120Medicare PIN