Provider Demographics
NPI:1285612747
Name:WOOD, ROBERT M (MD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:M
Last Name:WOOD
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 742616
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-2616
Mailing Address - Country:US
Mailing Address - Phone:770-848-6190
Mailing Address - Fax:770-848-5367
Practice Address - Street 1:1315 JESSE JEWELL PKWY NE
Practice Address - Street 2:SUITE 300
Practice Address - City:GAINESVILLE
Practice Address - State:GA
Practice Address - Zip Code:30501-3822
Practice Address - Country:US
Practice Address - Phone:770-848-6190
Practice Address - Fax:770-848-5367
Is Sole Proprietor?:No
Enumeration Date:2006-01-05
Last Update Date:2016-10-24
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GA077005207XX0004X, 207XS0114X, 207X00000X, 207XX0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0004XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryFoot and Ankle Surgery
No207XS0114XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryAdult Reconstructive Orthopaedic Surgery
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0100749Medicaid
MAJ22274OtherBCBS
MA155060OtherTUFTS
MA155060OtherTUFTS
MA0100749Medicaid