Healthcare Provider Details

I. General information

NPI: 1336899798
Provider Name (Legal Business Name): ANDREW JACOB WOODS DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/28/2022
Last Update Date: 04/20/2026
Certification Date: 04/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

250 PARK ST
BOWLING GREEN KY
42101-1795
US

IV. Provider business mailing address

225 ABRAHAM FLEXNER WAY STE 505
LOUISVILLE KY
40202-1896
US

V. Phone/Fax

Practice location:
  • Phone: 270-745-1000
  • Fax:
Mailing address:
  • Phone: 502-588-2160
  • Fax: 502-588-2161

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number05939
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: