Provider Demographics
NPI:1538276571
Name:WOOD, JAMES THOMAS (RPH, CDE)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:THOMAS
Last Name:WOOD
Suffix:
Gender:M
Credentials:RPH, CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 899
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:AL
Mailing Address - Zip Code:36274-0899
Mailing Address - Country:US
Mailing Address - Phone:334-863-7511
Mailing Address - Fax:334-863-7500
Practice Address - Street 1:3868 HIGHWAY 431
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:AL
Practice Address - Zip Code:36274-2640
Practice Address - Country:US
Practice Address - Phone:334-863-7511
Practice Address - Fax:334-863-7500
Is Sole Proprietor?:No
Enumeration Date:2006-08-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL9914183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist