Basic Information
| Provider Information | |||||||||
| NPI: | 1174186183 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | WOOD | ||||||||
| FirstName: | JAMES | ||||||||
| MiddleName: | L | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2245 NATOMA DR | ||||||||
| Address2: | |||||||||
| City: | VIRGINIA BEACH | ||||||||
| State: | VA | ||||||||
| PostalCode: | 234566914 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4053347482 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 329 EDWIN DR STE 100 | ||||||||
| Address2: | |||||||||
| City: | VIRGINIA BEACH | ||||||||
| State: | VA | ||||||||
| PostalCode: | 234624545 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7574642006 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/16/2019 | ||||||||
| LastUpdateDate: | 08/09/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/09/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208VP0014X | 0101271380 | VA | N | Allopathic & Osteopathic Physicians | Pain Medicine | Interventional Pain Medicine | 207R00000X | 0101271380 | VA | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.