Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YS0123X | Facial Plastic Surgeon | AZ22242 | AZ |
NPI | 1558329011 |
---|---|
Provider Name | Robert H Woods |
First Address | Chandler, AZ 85224-6239 |
Second Address | Scottsdale, AZ 85251-5627 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/05/2006 |
Last Update Date | 09/02/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F44386 | (02) |