Healthcare Provider Details

I. General information

NPI: 1275123663
Provider Name (Legal Business Name): WOODWARD PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/20/2021
Last Update Date: 03/20/2022
Certification Date: 02/21/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1460 E CALVADA BLVD
PAHRUMP NV
89048-5822
US

IV. Provider business mailing address

1460 E CALVADA BLVD
PAHRUMP NV
89048-5822
US

V. Phone/Fax

Practice location:
  • Phone: 775-210-8333
  • Fax: 775-346-9158
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JENNIFER PODVIN
Title or Position: DIRECTOR OF CREDENTIALING
Credential:
Phone: 725-529-2714