Provider Demographics
NPI:1942255690
Name:WOODS, ROBERT D II (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:D
Last Name:WOODS
Suffix:II
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:320 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:STE 120
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40509-1888
Practice Address - Country:US
Practice Address - Phone:859-276-4838
Practice Address - Fax:859-276-4638
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-23
Last Update Date:2011-02-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KY20654207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64206543Medicaid
KY64206543Medicaid
KY1299401Medicare ID - Type Unspecified