Basic Information
Provider Information | |||||||||
NPI: | 1598902983 | ||||||||
EntityType: | 1 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: |   | ||||||||
LastName: | WOOD | ||||||||
FirstName: | EVE | ||||||||
MiddleName: | ALLISON | ||||||||
NamePrefix: | DR. | ||||||||
NameSuffix: |   | ||||||||
Credential: | M.D. | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: |   | ||||||||
OtherFirstName: |   | ||||||||
OtherMiddleName: |   | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: |   | ||||||||
OtherLastNameType: |   | ||||||||
Mailing Information | |||||||||
Address1: | 950 E HARVARD AVE | ||||||||
Address2: | SUITE 200 | ||||||||
City: | DENVER | ||||||||
State: | CO | ||||||||
PostalCode: | 802107009 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 3036493200 | ||||||||
FaxNumber: | 3037656201 | ||||||||
Practice Location | |||||||||
Address1: | 1 FAMILY PRACTICE DR | ||||||||
Address2: |   | ||||||||
City: | KINGSTON | ||||||||
State: | NY | ||||||||
PostalCode: | 124016449 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 8453382562 | ||||||||
FaxNumber: | 8453388909 | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 01/07/2009 | ||||||||
LastUpdateDate: | 09/16/2019 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: | F | ||||||||
AuthorizedOfficialLastName: |   | ||||||||
AuthorizedOfficialFirstName: |   | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: |   | ||||||||
AuthorizedOfficialTelephone: |   | ||||||||
IsSoleProprietor: | N | ||||||||
IsOrganizationSubpart: |   | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: |   |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084P0800X | DR.0047205 | CO | N |   | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry | 2084P0800X | AZ 23199 | AZ | N |   | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry | 2084P0800X | PA MD034028E | PA | N |   | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry | 2084P0800X | 299168 | NY | Y |   | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry |
No ID Information.