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NPI Code Detail

MEDICARE: TIMOTHY J WOODLOCK MD

MEDICARE:   TIMOTHY J WOODLOCK  MD
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
1207RH0003XHematology & Oncology Physician153908NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1568499325
Entity Type Code : Individual
Provider Name (Legal Business Name) : TIMOTHY J WOODLOCK MD
Provider Business Mailing Address
First Line : 100 KINGS HWY S
Second Line :
City : ROCHESTER
State : NY
Zip : 14617-5504
Country : US
Telephone Number : 585-368-3172
Fax Number : 585-368-3337
Provider Business Practice Location Address
First Line : 55 GENESEE ST BLDG 1
Second Line :
City : ROCHESTER
State : NY
Zip : 14611-3201
Country : US
Telephone Number : 585-368-3591
Fax Number : 585-368-3337
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/27/2006
Last Update Date : 04/16/2021

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