=====================================================
General NPI Number Information
=====================================================
NPI Number | 1457465668
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ROBERT C WOODS M.D.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/18/2006
-----------------------------------------------------
Last Update Date | 10/21/2014
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 100 PHYSICIANS WAY SUITE 300
-----------------------------------------------------
City | LEBANON
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 37090-8102
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 615-449-6868
-----------------------------------------------------
Fax | 615-449-7184
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 501 GREAT CIRCLE RD SUITE 200
-----------------------------------------------------
City | NASHVILLE
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 37228-1317
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 615-449-6868
-----------------------------------------------------
Fax | 615-449-7184
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207RC0000X
-----------------------------------------------------
Taxonomy Name | Cardiovascular Disease Physician
-----------------------------------------------------
License Number | 25083
-----------------------------------------------------
License Number State | TN
-----------------------------------------------------