Wood MD PA

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

WOOD MD PA

Practice address

1605 W Main St
Russellville, AR 72801-2719

Phone

(479) 219-5008

Fax

(479) 219-5028

NPI assigned

Aug 3, 2017

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Lavon Jeneen Wood, MD

Title

Presiden

Phone

(479) 219-5008

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1501718400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658707200000",
    "number": "1447775192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1605 W MAIN ST",
            "city": "RUSSELLVILLE",
            "state": "AR",
            "postal_code": "728012719",
            "telephone_number": "479-219-5008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1605 W MAIN ST",
            "city": "RUSSELLVILLE",
            "state": "AR",
            "postal_code": "728012719",
            "telephone_number": "479-219-5008",
            "fax_number": "479-219-5028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOOD MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-03",
        "last_updated": "2022-07-25",
        "certification_date": "2022-07-25",
        "status": "A",
        "authorized_official_last_name": "WOOD",
        "authorized_official_first_name": "LAVON",
        "authorized_official_middle_name": "JENEEN",
        "authorized_official_title_or_position": "PRESIDEN",
        "authorized_official_telephone_number": "479-219-5008",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Craig Witcher, LPC
• Elizabeth Witt, COTA
• Kasey Wojtek, MA, LPC, CCTP-II
• Brandon James Wolfe
• Kaylee Jo Wolfe, APRN
• Lavon Jeneen Wood, M. D.
• Patricia L Wood, MHPP
• Sandra Lynn Wood, RN NURSE PRACTITIONE
• David B Woods, PD
• Maddisyn Woodward

• Family Medicine Physician in Russellville, AR
• Providers in Russellville, AR by specialty
• Family Medicine Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.