Provider Demographics
NPI:1033571617
Name:WOOD, JOSHUA HARLAND (MD)
Entity Type:Individual
Prefix:
First Name:JOSHUA
Middle Name:HARLAND
Last Name:WOOD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2345 E PRATER WAY STE 207
Mailing Address - Street 2:
Mailing Address - City:SPARKS
Mailing Address - State:NV
Mailing Address - Zip Code:89434-9634
Mailing Address - Country:US
Mailing Address - Phone:757-352-5335
Mailing Address - Fax:775-352-5334
Practice Address - Street 1:5265 VISTA BLVD BLDG B
Practice Address - Street 2:
Practice Address - City:SPARKS
Practice Address - State:NV
Practice Address - Zip Code:89436-0836
Practice Address - Country:US
Practice Address - Phone:775-352-5335
Practice Address - Fax:775-352-5334
Is Sole Proprietor?:No
Enumeration Date:2016-03-23
Last Update Date:2020-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV20121207QS0010X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports Medicine