Healthcare Provider Details

I. General information

NPI: 1598736670
Provider Name (Legal Business Name): DAVID ALBERT WOODARD M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/27/2006
Last Update Date: 04/14/2022
Certification Date: 04/14/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8333 N DAVIS HWY FL 4
PENSACOLA FL
32514-6050
US

IV. Provider business mailing address

8333 N DAVIS HWY FL 4
PENSACOLA FL
32514-6050
US

V. Phone/Fax

Practice location:
  • Phone: 706-475-1700
  • Fax: 706-475-1790
Mailing address:
  • Phone: 850-969-7979
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number059977
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License Number059977
License Number StateGA
# 3
Primary TaxonomyY
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License NumberME150151
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: