DR. GORDON STACEY WOOD (NPI# 1255328969) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255328969 |
| Entity Type | Individual |
| Full Name | DR. GORDON STACEY WOOD |
| Credential | M.D. |
| Practice Address |
2380 N 400 E Suite D North Logan UT 84341-1749 |
| Mailing Address |
2380 N 400 E Suite #d North Logan UT 84341-1749 |
| Practice Telephone | 4357537880 |
| Practice Fax Number | 4357535845 |
| Mailing Telephone | 4357537880 |
| Mailing Fax Number | 4357535845 |
| Enumeration Date | 2005-09-29 |
| Last Update Date | 2007-10-05 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207YX0007X |
Otolaryngology Specialization: Plastic Surgery within the Head & Neck |
185282-1205 | UT | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730390766 | Gordon J Wood | Internal Medicine | 2050 Claire Ct, Glenview, IL 60025-7635 | 2007-05-24 |
| 1225103781 | Gordon Chase Wood | Pediatrics | 830 W End Ct, Suite 500, Vernon Hills, IL 60061-1365 | 2006-11-21 |
| Street Address |
2380 N 400 E SUITE D |
| City | NORTH LOGAN |
| State | UT |
| Zip Code | 84341-1749 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396731469 | Jeffrey Green Bennion | Otolaryngology | 2380 N 400 E, Suite #d, North Logan, UT 84341-1749 | 2005-09-23 |
| 1528438140 | Jamie Coy Grange | Physician Assistant | 2380 N 400 E, Suite D, North Logan, UT 84341-6000 | 2015-09-25 |
| 1952703472 | Mountain Division - Cvh, LLC | General Acute Care Hospital | 2380 N 400 E, North Logan, UT 84341-6000 | 2014-09-17 |
| 1245673946 | Ashley Anne Crum | Emergency Medicine | 2380 N 400 E, North Logan, UT 84341-6000 | 2013-04-11 |
| 1861731549 | Pauline Margaret Jonsson | Occupational Therapist | 2380 N 400 E, North Logan, UT 84341-6000 | 2013-01-31 |
| 1588969539 | Primary Care Pediatrics | Pediatrics | 2380 N 400 E, Suite C, North Logan, UT 84341-1756 | 2011-01-24 |
| 1922312420 | Jaclyn Castronova | Nurse Practitioner | 2380 N 400 E, Ste A, North Logan, UT 84341-6000 | 2010-07-27 |
| 1609195031 | University of Utah Cache Valley Emergency Medicine | Emergency Medicine | 2380 N 400 E, North Logan, UT 84341-6000 | 2010-05-25 |
| 1215250493 | Wood Wound Care, LLC | Surgery | 2380 N 400 E, Suite H, North Logan, UT 84341-6000 | 2010-03-02 |
| 1295996700 | Barrett Paul Labrum | Pediatrics | 2380 N 400 E, North Logan, UT 84341-1756 | 2008-06-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538701529 | Aubrey Salmond | Registered Nurse | 500 East 1500 N, Logan, UT 84341 | 2019-10-11 |
| 1043702046 | Eye Pros of Logan LLC | Optometrist | 1475 N Main St Ste 103, Logan, UT 84341 | 2018-06-05 |
| 1275050452 | Rylie Jeanne Cook | Student in an Organized Health Care Education/Training Program | 11 Aggie Village Apt. J, Logan, UT 84341 | 2017-08-28 |
| 1093262156 | Jessica Lynn Mcgarry | Social Worker | 1040 N 130 W, Apt 100, Logan, UT 84341 | 2016-09-07 |
| 1740663566 | Paul R Gregory | Occupational Therapy Assistant | 1300 N 500 E Suite 120, Suite 120, Logan, UT 84341 | 2015-06-30 |
| 1851708846 | Bradley Budge | Optometrist | 535 E 1400 N Ste 130, Logan, UT 84341 | 2014-07-22 |
| 1386058709 | Daniel Raymond Carlson | Physician Assistant | 500 E. 1400 N., Logan, UT 84341 | 2014-06-13 |
| 1902220239 | Work Injury Solutions Inc. | Clinic/Center | 630 E 1400 N Ste 140, Logan, UT 84341 | 2014-02-06 |
| 1750627287 | Lee Martin Williams Sr. | Counselor | 186 E. 1800 N., North Logan, UT 84341 | 2013-01-03 |
| 1669747804 | Ronald J Payne | Internal Medicine | 1726 North 1850 East, North Logan, UT 84341 | 2012-03-21 |
| Find all providers in zip 84341 | ||||
| Taxonomy Code | 207YX0007X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Otolaryngology |
| Specialization | Plastic Surgery within the Head & Neck |
| An otolaryngologist with additional training in plastic and reconstructive procedures within the head, face, neck and associated structures, including cutaneous head and neck oncology and reconstruction, management of maxillofacial trauma, soft tissue repair and neural surgery. The field is diverse and involves a wide age range of patients, from the newborn to the aged. While both cosmetic and reconstructive surgeries are practiced, there are many additional procedures which interface with them. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added] Additional Resources: American Board of Otolaryngology, 2007. http://www.aboto.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Otolaryngology. Board certification for Doctors of Osteopathy is currently provided in the subspecialty of Otolaryngology/Facial Plastic Surgery (see Taxonomy Code 207YX0905X) |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396731469 | Jeffrey Green Bennion | Otolaryngology | 2380 N 400 E, Suite #d, North Logan, UT 84341-1749 | 2005-09-23 |
| 1548303795 | Gibbons Wood and Bennion, PC. | Otolaryngology | 2380 N 400 E, North Logan, UT 84341-1749 | 2007-02-15 |
| 1962499673 | James Wallentine Blotter | Otolaryngology | 2380 N 400 E, Suite #d, North Logan, UT 84341-1749 | 2005-09-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700290178 | Sarah Drejet | Otolaryngology | 1950 Circle of Hope Dr, Salt Lake City, UT 84112-5500 | 2014-06-13 |
| 1811283393 | Castleview Physician Practices, LLC | Otolaryngology | 945 W Hospital Dr, Suite #1, Price, UT 84501-4214 | 2011-06-23 |
| 1215253182 | Gretchen Mae Oakley | Otolaryngology | 50 N Medical Dr, Suite 3c120, Salt Lake City, UT 84132-0001 | 2010-04-15 |
| 1356378095 | Scott Kent Thompson | Otolaryngology | 1551 Renaissance Towne Dr, Suite 310, Bountiful, UT 84010-7667 | 2006-06-27 |
| City | NORTH LOGAN |
| Zip Code | 84341 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.