Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2081P2900X | Pain Medicine | 072442 | GA |
Y | 208D00000X | General Practice Physician | UO2219 | FL |
NPI | 1407089410 |
---|---|
Provider Name | Rajiv Sood |
First Address | Jonesboro, GA 30236 |
Second Address | Jonesboro, GA 30236 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/08/2009 |
Last Update Date | 12/06/2015 |