Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 35065194 | OH |
Y | 208600000X | Surgeon | 35065194 | OH |
N | 2086S0102X | Surgical Critical Care | 35065194 | OH |
NPI | 1013973098 |
---|---|
Provider Name | Randy J Woods |
First Address | Dayton, OH 45435-0001 |
Second Address | Dayton, OH 45409 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/04/2006 |
Last Update Date | 03/04/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0148610 | (05) | OH |
H32536 | (02) |