Healthcare Provider Details

I. General information

NPI: 1467571331
Provider Name (Legal Business Name): ROBERT D WOODS II, MD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/29/2007
Last Update Date: 09/09/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

230 FOUNTAIN CT SUITE 120
LEXINGTON KY
40509-1896
US

IV. Provider business mailing address

230 FOUNTAIN CT SUITE 120
LEXINGTON KY
40509-1896
US

V. Phone/Fax

Practice location:
  • Phone: 859-276-4838
  • Fax: 859-276-4638
Mailing address:
  • Phone: 859-276-4838
  • Fax: 859-276-4638

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number20654
License Number StateKY

VIII. Authorized Official

Name: DR. ROBERT D WOODS II
Title or Position: PHYSICIAN
Credential: M.D.
Phone: 859-276-4838