Provider Demographics
NPI:1487752689
Name:WOOD, TYLER H (PHARMD)
Entity type:Individual
Prefix:DR
First Name:TYLER
Middle Name:H
Last Name:WOOD
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:422 MOUNTAIN EDGE
Mailing Address - Street 2:
Mailing Address - City:VAN BUREN
Mailing Address - State:AR
Mailing Address - Zip Code:72956-9041
Mailing Address - Country:US
Mailing Address - Phone:479-474-3906
Mailing Address - Fax:
Practice Address - Street 1:18 HWY 162 SO
Practice Address - Street 2:
Practice Address - City:ALMA
Practice Address - State:AR
Practice Address - Zip Code:72921-0168
Practice Address - Country:US
Practice Address - Phone:479-632-2248
Practice Address - Fax:479-632-2386
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2008-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPD10199183500000X, 1835N0905X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No1835N0905XPharmacy Service ProvidersPharmacistNuclear