Healthcare Provider Details

I. General information

NPI: 1356563043
Provider Name (Legal Business Name): WOODARD, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/03/2007
Last Update Date: 04/21/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5105 S SHERIDAN RD
TULSA OK
74145-7627
US

IV. Provider business mailing address

5105 S SHERIDAN RD
TULSA OK
74145-7627
US

V. Phone/Fax

Practice location:
  • Phone: 918-712-9990
  • Fax: 918-712-9390
Mailing address:
  • Phone: 918-712-9990
  • Fax: 918-712-9390

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License NumberA251
License Number StateOK

VIII. Authorized Official

Name: DR. ROBERT E WOODARD
Title or Position: OWNER
Credential: PHD
Phone: 918-712-9990