Healthcare Provider Details

I. General information

NPI: 1164424651
Provider Name (Legal Business Name): WILLIAM BRENDAN WOODS DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/15/2005
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1932 NILES CORTLAND RD NE STE P
WARREN OH
44484-1055
US

IV. Provider business mailing address

1932 NILES CORTLAND RD NE STE P
WARREN OH
44484-1055
US

V. Phone/Fax

Practice location:
  • Phone: 330-306-0395
  • Fax: 330-306-5391
Mailing address:
  • Phone: 330-306-0395
  • Fax: 330-306-5391

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberOS013247
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number34008821
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: