MEDICARE: DR. ROBERT M WOOD MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	29388	TN

General Provider Information

NPI Number	:	1578548392
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERT M WOOD MD

Provider Business Mailing Address
First Line	:	4519 HIXSON PIKE
Second Line	:
City	:	HIXSON
State	:	TN
Zip	:	37343-5035
Country	:	US
Telephone Number	:	423-877-4591
Fax Number	:	423-877-4225

Provider Business Practice Location Address
First Line	:	4519 HIXSON PIKE
Second Line	:
City	:	HIXSON
State	:	TN
Zip	:	37343-5035
Country	:	US
Telephone Number	:	423-877-4591
Fax Number	:	423-877-4225

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/14/2005
Last Update Date	:	01/14/2009

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