Healthcare Provider Details

I. General information

NPI: 1275636516
Provider Name (Legal Business Name): JOHN WOODRING M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/05/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1101 VETERANS DRIVE
LEXINGTON KY
40502
US

IV. Provider business mailing address

336 ARCADIA PARK
LEXINGTON KY
40503-1313
US

V. Phone/Fax

Practice location:
  • Phone: 859-233-4511
  • Fax:
Mailing address:
  • Phone: 859-277-5927
  • Fax: 859-277-5927

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number19044
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: