Provider Demographics
NPI:1497718332
Name:WOOD, ROBERT WAYNE (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:WAYNE
Last Name:WOOD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:R.
Other - Middle Name:WAYNE
Other - Last Name:WOOD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:6567 E CARONDELET DR
Mailing Address - Street 2:SUITE 415
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85710-2156
Mailing Address - Country:US
Mailing Address - Phone:520-885-6701
Mailing Address - Fax:520-885-9037
Practice Address - Street 1:6567 E CARONDELET DR
Practice Address - Street 2:SUITE 415
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85710-2156
Practice Address - Country:US
Practice Address - Phone:520-885-6701
Practice Address - Fax:520-885-9037
Is Sole Proprietor?:No
Enumeration Date:2006-04-11
Last Update Date:2008-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ9384207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ201020-10Medicaid
AZ20-3604285OtherTIN
AZ20-3604285OtherTIN
E39798Medicare UPIN