Healthcare Provider Details

I. General information

NPI: 1003034778
Provider Name (Legal Business Name): KAREN L WOODARD DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/20/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

160 MCCLUNG STREET
PHIL CAMPBELL AL
35581
US

IV. Provider business mailing address

PO BOX 130
PHIL CAMPBELL AL
35581-0130
US

V. Phone/Fax

Practice location:
  • Phone: 205-993-5341
  • Fax: 205-993-5358
Mailing address:
  • Phone: 205-993-5341
  • Fax: 205-993-5358

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number3562
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: