Male or Other

Charles E. Wood PA-C

Physician Assistant in Jacksonville, FL(View on Map)

Full Name

Charles E Wood PA-C

NPI Number

1235193400

NPI Type

Individual Provider

Gender

Male

Enumeration Date

04/14/2006

Specialties

(Taxonomies)

Code

363A00000X
363AS0400X

Primary Taxonomy

Yes
No

Licenses

State

Florida

License Number

PA2616

Contact
Information

Purpose

Mailing
Location

Address

PO BOX 746654
1301 PALM AVE STE 600

City

Atlanta
Jacksonville

State

GA
FL

Postal Code

30374-6654
32207-8432

Country

US
US

Telephone Number

(904) 202-2092
(904) 202-7300

Identifiers

Identifier

290017300
970009795
P00088264

Identifier State

FL
Unknown
Unknown

Identifier Issuer

Unknown
RAILROAD MEDICARE
RAILROAD MEDICARE

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 03/26/2024

Provider Address

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