| Wood Healthcare Pllc | |
|
1012 Ladera Dr Marvin NC 28173-0043 | |
| (513) 515-9225 | |
| Not Available |
| Full Name | Wood Healthcare Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 1012 Ladera Dr, Marvin, North Carolina |
| Authorized Official Name and Position | Zackary Wood (OWNER) |
| Authorized Official Contact | 5135159225 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Wood Healthcare Pllc 1012 Ladera Dr Marvin NC 28173-0043 Ph: () - | Wood Healthcare Pllc 1012 Ladera Dr Marvin NC 28173-0043 Ph: (513) 515-9225 |
| NPI Number | 1366192288 |
|---|---|
| Provider Enumeration Date | 03/24/2022 |
| Last Update Date | 06/16/2022 |
| Medicare PECOS PAC ID | 2769862218 |
|---|---|
| Medicare Enrollment ID | O20220630001747 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366192288 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Zackery Shane Wood |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1659665289 PECOS PAC ID: 2365600749 Enrollment ID: I20190306000698 |
| Provider Name | Latifah Quanah Jeter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184381659 PECOS PAC ID: 3870977960 Enrollment ID: I20220909000235 |
| Provider Name | April Jasmine Bland |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679234280 PECOS PAC ID: 9234514175 Enrollment ID: I20220914000103 |