| John O. Wood Psychological Services | |
|
1906 Greenwood Dr Suite B Poplar Bluff MO 63901-2430 | |
| (573) 778-3913 | |
| (573) 778-0925 |
| Full Name | John O. Wood Psychological Services |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 1906 Greenwood Dr, Poplar Bluff, Missouri |
| Authorized Official Name and Position | John Owen Wood (OWNER) |
| Authorized Official Contact | 5737783913 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| John O. Wood Psychological Services 1906 Greenwood Dr Suite B Poplar Bluff MO 63901-2430 Ph: (573) 778-3913 | John O. Wood Psychological Services 1906 Greenwood Dr Suite B Poplar Bluff MO 63901-2430 Ph: (573) 778-3913 |
| NPI Number | 1346560869 |
|---|---|
| Provider Enumeration Date | 06/07/2010 |
| Last Update Date | 06/07/2010 |
| Medicare PECOS PAC ID | 4082744594 |
|---|---|
| Medicare Enrollment ID | O20100610000085 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346560869 | NPI | - | NPPES |
| 493461404 | Medicaid | MO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 01540 (Missouri) | Primary |
| Provider Name | John O Wood |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1124035449 PECOS PAC ID: 2163552670 Enrollment ID: I20100610000105 |
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