Wood, Jeffery Shane
Wood, Jeffery Shane is an sole proprietor health care provider with primary practice located at 700 Wildwood Plantation Dr , Valdosta GA 31602-3606. He recently has only one registered license in Dental Providers / Oral and Maxillofacial Surgery, which is considered as his primary health care specialty. Wood, Jeffery Shane can be contacted via phone (229) 241-1010.Contact Information
Primary practice address
700 Wildwood Plantation Dr
Valdosta GA 31602-3606
Phone: (229) 241-1010
Fax: (229) 293-0900
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Oral and Maxillofacial Surgery | 1223S0112X | DN011649 | Georgia |
Profile Details
| NPI number | 1992848659 |
|---|---|
| LBN Legal business name | Wood, Jeffery Shane |
| Credentials | Doctor of Dental Medicine (DMD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Feb 14th, 2007 |
| Last updated | Jul 8th, 2007 - about 19 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 | 1992848659 | NPPES |
| Georgia | MEDICAID | 000752067A | |
| Georgia | Other | 582312881 |
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