Provider Demographics
NPI:1497907323
Name:WOODS, RANDALL (DO)
Entity Type:Individual
Prefix:DR
First Name:RANDALL
Middle Name:
Last Name:WOODS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24219 S DESERT VALE DR
Mailing Address - Street 2:
Mailing Address - City:SUN LAKES
Mailing Address - State:AZ
Mailing Address - Zip Code:85248
Mailing Address - Country:US
Mailing Address - Phone:480-710-7988
Mailing Address - Fax:
Practice Address - Street 1:24219 S DESERT VALE DR
Practice Address - Street 2:
Practice Address - City:SUN LAKES
Practice Address - State:AZ
Practice Address - Zip Code:85248
Practice Address - Country:US
Practice Address - Phone:480-710-7988
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-22
Last Update Date:2016-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ2037207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology