Healthcare Provider Details

I. General information

NPI: 1952350506
Provider Name (Legal Business Name): WOODROW W HERRING III M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/10/2006
Last Update Date: 01/27/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 20TH AVE E
JASPER AL
35501-4070
US

IV. Provider business mailing address

801 20TH AVE E
JASPER AL
35501-4070
US

V. Phone/Fax

Practice location:
  • Phone: 205-385-2016
  • Fax:
Mailing address:
  • Phone: 205-385-2016
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number00021959
License Number StateAL
# 2
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number00021959
License Number StateAL
# 3
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number00021959
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: