Wood, Lavon Jeneen
Wood, Lavon Jeneen is an individual health care provider with primary practice located at 108 Skyline Dr , Russellville AR 72801-3362. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Wood, Lavon Jeneen can be contacted via phone (479) 968-7170.Contact Information
Primary practice address
108 Skyline Dr
Russellville AR 72801-3362
Phone: (479) 968-7170
Fax: (479) 890-2467
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | E-6054 | Arkansas |
Profile Details
| NPI number | 1427251776 |
|---|---|
| LBN Legal business name | Wood, Lavon Jeneen |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 6th, 2007 |
| Last updated | Mar 10th, 2017 - about 7 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1427251776 | NPPES |
| Arkansas | MEDICAID | 183739001 |
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