Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 077005 | GA |
N | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | 077005 | GA |
N | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | 077005 | GA |
NPI | 1285612747 |
---|---|
Provider Name | Dr. Robert M. Wood |
First Address | Atlanta, GA 30374-2616 |
Second Address | Gainesville, GA 30501-3822 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/01/2006 |
Last Update Date | 24/10/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0100749 | (05) | MA |
155060 | TUFTS (01) | MA |
H16595 | (02) | |
J22274 | BCBS (01) | MA |