Provider Demographics
NPI:1316169923
Name:NORMAN E WOOD, DO
Entity type:Organization
Organization Name:NORMAN E WOOD, DO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NORMAN
Authorized Official - Middle Name:E
Authorized Official - Last Name:WOOD
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:304-233-2455
Mailing Address - Street 1:109 MOUNT WOOD RD
Mailing Address - Street 2:
Mailing Address - City:WHEELING
Mailing Address - State:WV
Mailing Address - Zip Code:26003-2632
Mailing Address - Country:US
Mailing Address - Phone:304-233-2455
Mailing Address - Fax:304-233-6073
Practice Address - Street 1:703 5TH ST
Practice Address - Street 2:
Practice Address - City:MOUNDSVILLE
Practice Address - State:WV
Practice Address - Zip Code:26041-1959
Practice Address - Country:US
Practice Address - Phone:304-233-2455
Practice Address - Fax:304-233-6073
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0627414Medicaid
WV0049346000Medicaid
OHSP02061Medicare ID - Type Unspecified
WV0049346000Medicaid