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Deactivated NPI 1861504722 Deactivated / Inactive NPI Male Practitioner

Wallace John Wood , PA, C

Physician Assistant • Globe, AZ

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Wallace Wood has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date August 31, 2006
NPI Deactivation Date January 21, 2020
Total Practice Duration ~14 Years of Practice (2006 – 2020)

Professional Overview & Biography Verified Profile Summary

Wallace Wood, PA, C was a registered Physician Assistant practicing in Globe, AZ. Throughout an active medical career spanning 14 years, Wallace Wood provided care at the practice location at 707 S BROAD ST until profile deactivation on 2020-01-21.

Practice Location & Contact Primary Location

Practice Address

707 S Broad St
Globe Va Mobile Clinic

Globe, AZ 855012615

Telephone 9284250027
Fax 9284250028

Specialty Benchmarks & Practice Insights

Comparative analytics for Physician Assistant in Globe, AZ

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 14.3 Yrs
State Avg: 12.5 Yrs
Regional Practice Density
10 Specialists

Practicing in Globe, AZ (3711 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Physician Assistant Primary Specialty

NUCC Taxonomy Code: 363A00000X

State License AZ 1525

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated January 21, 2020

Record deactivated on January 21, 2020

NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

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Updated Practice Location July 08, 2007

Registered at 707 S BROAD ST, GLOBE VA MOBILE CLINIC, GLOBE, AZ 855012615 (Tel: 9284250027)

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Updated Business Mailing Address July 08, 2007

Registered at 707 S BROAD ST, GLOBE VA MOBILE CLINIC, GLOBE, AZ 855012615 (Tel: 9284250027)

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Provider Name / Credentials Updated July 08, 2007

Recorded as WALLACE WOOD, PA/C

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Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Physician Assistant (License #1525 in AZ)

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Initial NPI Registration & Enumeration August 31, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1861504722
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: August 31, 2006
Last Update: July 08, 2007
Deactivation Date: January 21, 2020

Mailing Address

707 S Broad St, Globe Va Mobile Clinic

Globe, AZ 855012615

Phone: 9284250027

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.