Provider Demographics
NPI:1265542757
Name:WOOD, NEIL LIPSCOMB JR (MD)
Entity type:Individual
Prefix:
First Name:NEIL
Middle Name:LIPSCOMB
Last Name:WOOD
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:11985 HERITAGE OAK PL
Mailing Address - Street 2:#220
Mailing Address - City:AUBURN
Mailing Address - State:CA
Mailing Address - Zip Code:95603-2461
Mailing Address - Country:US
Mailing Address - Phone:530-888-6322
Mailing Address - Fax:530-888-6338
Practice Address - Street 1:11985 HERITAGE OAK PL
Practice Address - Street 2:#220
Practice Address - City:AUBURN
Practice Address - State:CA
Practice Address - Zip Code:95603-2461
Practice Address - Country:US
Practice Address - Phone:530-888-6322
Practice Address - Fax:530-888-6338
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2007-07-24
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Provider Licenses
StateLicense IDTaxonomies
CAC36813207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00C368130Medicare ID - Type Unspecified
A36376Medicare UPIN