| Dr Zackery Shane Wood, DO | |
|
1012 Ladera Dr, Marvin, NC 28173-0043 | |
| (513) 515-9225 | |
| (813) 336-8376 |
| Full Name | Dr Zackery Shane Wood |
|---|---|
| Gender | Male |
| Speciality | Family Medicine |
| Location | 1012 Ladera Dr, Marvin, North Carolina |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659665289 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 2018-02888 (North Carolina) | Primary |
| Entity Name | Sensenbrenner Primary Care, Pllc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1205813755 PECOS PAC ID: 9234171315 Enrollment ID: O20050531000241 |
| Entity Name | Inpatient Consultants Of North Carolina Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1669422846 PECOS PAC ID: 5991720591 Enrollment ID: O20051012001172 |
| Entity Name | Horizon Internal Medicine Pllc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1033353941 PECOS PAC ID: 0446391544 Enrollment ID: O20100112000441 |
| Entity Name | Nm Pacs 2 Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1366928749 PECOS PAC ID: 3375892060 Enrollment ID: O20200109003016 |
| Entity Name | Mainstreet And Kidsstreet Of North Carolina Pllc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1144803040 PECOS PAC ID: 6901290238 Enrollment ID: O20220302000414 |
| Entity Name | Cs Pacs 3 Southeast Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1154104958 PECOS PAC ID: 8426404302 Enrollment ID: O20240815002813 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Zackery Shane Wood, DO 1012 Ladera Dr, Marvin, NC 28173-0043 Ph: (513) 515-9225 | Dr Zackery Shane Wood, DO 1012 Ladera Dr, Marvin, NC 28173-0043 Ph: (513) 515-9225 |