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NPI Code Detail

MEDICARE: DR. JOSEPH VINCENT WOODRING DO

MEDICARE: DR. JOSEPH VINCENT WOODRING DO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine PhysicianDOSR-69HI

General Provider Information

NPI Number : 1366428781
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JOSEPH VINCENT WOODRING DO
Provider Business Mailing Address
First Line : 98-1494 HOOMAHIE LOOP
Second Line :
City : PEARL CITY
State : HI
Zip : 96782-2325
Country : US
Telephone Number : 720-838-4270
Fax Number :
Provider Business Practice Location Address
First Line : 98-1494 HOOMAHIE LOOP
Second Line :
City : PEARL CITY
State : HI
Zip : 96782-2325
Country : US
Telephone Number : 720-838-4270
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/17/2005
Last Update Date : 07/08/2007

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