Healthcare Provider Details

I. General information

NPI: 1730556747
Provider Name (Legal Business Name): WOODS SERVICES MEDICAL GROUP PRACTICE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/25/2015
Last Update Date: 08/25/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40 MARTIN GROSS DR
LANGHORNE PA
19047-1616
US

IV. Provider business mailing address

40 MARTIN GROSS DR
LANGHORNE PA
19047-1616
US

V. Phone/Fax

Practice location:
  • Phone: 215-750-4000
  • Fax: 215-750-4591
Mailing address:
  • Phone: 215-750-4000
  • Fax: 215-750-4591

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code204D00000X
TaxonomyNeuromusculoskeletal Medicine & OMM Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number
License Number State

VIII. Authorized Official

Name: DR. SCOTT SPREAT
Title or Position: PRESIDENT/CEO
Credential:
Phone: 215-750-4000