Provider Demographics
NPI:1467571331
Name:ROBERT D WOODS II, MD
Entity Type:Organization
Organization Name:ROBERT D WOODS II, MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:D
Authorized Official - Last Name:WOODS
Authorized Official - Suffix:II
Authorized Official - Credentials:MD
Authorized Official - Phone:859-276-4838
Mailing Address - Street 1:230 FOUNTAIN CT
Mailing Address - Street 2:SUITE 120
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40509-1896
Mailing Address - Country:US
Mailing Address - Phone:859-276-4838
Mailing Address - Fax:859-276-4638
Practice Address - Street 1:230 FOUNTAIN CT
Practice Address - Street 2:SUITE 120
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40509-1896
Practice Address - Country:US
Practice Address - Phone:859-276-4838
Practice Address - Fax:859-276-4638
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-29
Last Update Date:2011-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY20654207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64206543Medicaid
KYC74133Medicare UPIN
KY64206543Medicaid