Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | 35-038656 | OH |
NPI | 1003814872 |
---|---|
Provider Name | Dr. Thom Wood |
First Address | Newark, OH 43055-1822 |
Second Address | Newark, OH 43055-1822 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/07/2005 |
Last Update Date | 08/07/2007 |