Provider Demographics
NPI:1548250343
Name:WOOD, JAMES PLATT (MD)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:PLATT
Last Name:WOOD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:19475 W NORTH AVE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:BROOKFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:53045-4199
Mailing Address - Country:US
Mailing Address - Phone:262-395-4141
Mailing Address - Fax:262-395-4159
Practice Address - Street 1:19475 W NORTH AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:BROOKFIELD
Practice Address - State:WI
Practice Address - Zip Code:53045-4199
Practice Address - Country:US
Practice Address - Phone:262-395-4141
Practice Address - Fax:262-395-4159
Is Sole Proprietor?:No
Enumeration Date:2005-10-24
Last Update Date:2013-01-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WI23707020207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI30423200Medicaid
WI000301410Medicare ID - Type Unspecified
WI30423200Medicaid
WIB55720Medicare UPIN