Provider Demographics
NPI:1477558419
Name:SOOD, RANJIT KUMAR (MD)
Entity Type:Individual
Prefix:DR
First Name:RANJIT
Middle Name:KUMAR
Last Name:SOOD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:633 E COTTONWOOD LN
Mailing Address - Street 2:STE B
Mailing Address - City:CASA GRANDE
Mailing Address - State:AZ
Mailing Address - Zip Code:85222-2056
Mailing Address - Country:US
Mailing Address - Phone:520-836-1579
Mailing Address - Fax:520-421-3423
Practice Address - Street 1:633 E COTTONWOOD LN
Practice Address - Street 2:STE B
Practice Address - City:CASA GRANDE
Practice Address - State:AZ
Practice Address - Zip Code:85222-2056
Practice Address - Country:US
Practice Address - Phone:520-836-1579
Practice Address - Fax:520-421-3423
Is Sole Proprietor?:No
Enumeration Date:2005-06-16
Last Update Date:2007-10-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ10691208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ229791Medicaid
AZ229791Medicaid