Doctor Name: | NANCY KEIM WOODRUFF |
NPI Number: | 1730153776 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MD |
License Number: | 18230 |
Business Practice Address: | 108 Se Ave N Idabel, OK - 74745 |
Business Phone Number: | 5802864343 |
Business Fax Number: | 5802864333 |
Mailing Address: | 108 Se Ave N, IDABEL |
State: | OK |
Postal Code: | 74745 |
Phone Number: | 5802864343 |
Fax Number: | 5802864333 |
NPI Enumeration Date: | 02/15/2006 |
NPI Last Update Date: | 06/30/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 18230 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OK |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |