Healthcare Provider Details

I. General information

NPI: 1891011961
Provider Name (Legal Business Name): HEATHER WOODIN COLE M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: HEATHER KATIE WOODIN M.D.

II. Dates (important events)

Enumeration Date: 04/14/2010
Last Update Date: 09/28/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3126 N CIVIC CENTER PLZ
SCOTTSDALE AZ
85251-6912
US

IV. Provider business mailing address

3126 N CIVIC CENTER PLZ
SCOTTSDALE AZ
85251-6912
US

V. Phone/Fax

Practice location:
  • Phone: 480-874-2040
  • Fax: 480-874-2041
Mailing address:
  • Phone: 480-874-2040
  • Fax: 480-874-2041

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XX0801X
TaxonomyOrthopaedic Trauma Physician
License Number49950
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: