Healthcare Provider Details

I. General information

NPI: 1720578198
Provider Name (Legal Business Name): THOMAS ANDREW WOZNY MD, BS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/11/2018
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3301 C ST STE 1500
SACRAMENTO CA
95816-3371
US

IV. Provider business mailing address

4860 Y ST STE 3740
SACRAMENTO CA
95817-2307
US

V. Phone/Fax

Practice location:
  • Phone: 916-734-7463
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License NumberA174636
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: