| Kenneth W Wood Md Llc | |
|
315 N Washington Ave Ste 130 Cookeville TN 38501-2623 | |
| (931) 854-9880 | |
| (931) 854-0919 |
| Full Name | Kenneth W Wood Md Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 315 N Washington Ave Ste 130, Cookeville, Tennessee |
| Authorized Official Name and Position | Kenneth W Wood (MD) |
| Authorized Official Contact | 9318549880 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kenneth W Wood Md Llc 315 N Washington Ave Ste 130 Cookeville TN 38501-2623 Ph: (931) 854-9880 | Kenneth W Wood Md Llc 315 N Washington Ave Ste 130 Cookeville TN 38501-2623 Ph: (931) 854-9880 |
| NPI Number | 1467748772 |
|---|---|
| Provider Enumeration Date | 06/24/2011 |
| Last Update Date | 12/19/2023 |
| Medicare PECOS PAC ID | 3577731603 |
|---|---|
| Medicare Enrollment ID | O20110715000539 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467748772 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Kenneth W Wood |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1336131705 PECOS PAC ID: 8921098252 Enrollment ID: I20040517001417 |
| Provider Name | Brooke M Hewett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114475829 PECOS PAC ID: 6305182668 Enrollment ID: I20190108003073 |
| Provider Name | Macy Brooke Phillips |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801540679 PECOS PAC ID: 4385031764 Enrollment ID: I20220504000792 |
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