Healthcare Provider Details

I. General information

NPI: 1033139167
Provider Name (Legal Business Name): HUNTER E WOODALL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/20/2006
Last Update Date: 04/21/2020
Certification Date: 04/21/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 E GREENVILLE ST SUITE 3700
ANDERSON SC
29621-1580
US

IV. Provider business mailing address

800 N FANT ST
ANDERSON SC
29621-5708
US

V. Phone/Fax

Practice location:
  • Phone: 864-512-1475
  • Fax: 864-512-1930
Mailing address:
  • Phone: 864-512-1475
  • Fax: 864-512-1930

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207QH0002X
TaxonomyHospice and Palliative Medicine (Family Medicine) Physician
License Number13147
License Number StateSC
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number13147
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: