Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | 20121 | NV |
N | 207QS0010X | Family Doctor - Sports Medicine | 20121 | NV |
NPI | 1033571617 |
---|---|
Provider Name | Joshua Harland Wood |
First Address | Sparks, NV 89434-9634 |
Second Address | Sparks, NV 89436-0836 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/03/2016 |
Last Update Date | 23/07/2020 |