Healthcare Provider Details

I. General information

NPI: 1831552892
Provider Name (Legal Business Name): ROBERT FRANKLIN WOOD JR. M.D., M.P.H.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/29/2016
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1214 COOLIDGE BLVD
LAFAYETTE LA
70503-2621
US

IV. Provider business mailing address

1214 COOLIDGE BLVD 3RD FLOOR-PATHOLOGY
LAFAYETTE LA
70503-2621
US

V. Phone/Fax

Practice location:
  • Phone: 337-739-5577
  • Fax:
Mailing address:
  • Phone: 337-739-5577
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207ZC0006X
TaxonomyClinical Pathology Physician
License Number342620
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code207ZH0000X
TaxonomyHematology (Pathology) Physician
License Number342620
License Number StateLA
# 3
Primary TaxonomyN
Taxonomy Code207ZP0007X
TaxonomyMolecular Genetic Pathology (Pathology) Physician
License Number342620
License Number StateLA
# 4
Primary TaxonomyY
Taxonomy Code207ZP0101X
TaxonomyAnatomic Pathology Physician
License Number342620
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: