Healthcare Provider Details
I. General information
NPI: 1477551885
Provider Name (Legal Business Name): ROBINGTON J.O. WOODS D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 07/09/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
684 HARVEY ST SUITE 201
MUSKEGON MI
49442-4274
US
IV. Provider business mailing address
684 HARVEY ST SUITE 201
MUSKEGON MI
49442-4274
US
V. Phone/Fax
- Phone: 231-773-7837
- Fax: 231-773-7943
- Phone: 231-773-7837
- Fax: 231-773-7943
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | RW013395 |
| License Number State | MI |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: