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General NPI Number Information
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NPI Number | 1093458077
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Entity Type | Individual
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Provider Name | BOBBY R WOODARD JR. DPH
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Gender | Male
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Dates
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Enumeration Date | 04/18/2022
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Last Update Date | 04/18/2022
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Provider Practice Location Address
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Address Line | WESTVIEW PHARMACY 3606 N. MARTIN LUTHER KING
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City | TULSA
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State | OK
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Zip | 74106
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Country | US
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Telephone | 918-425-1385
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Fax |
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Provider Business Mailing Address
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Address Line | 1927 N. 24TH W: AVE
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City | TULSA
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State | OK
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Zip | 74127
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Country | US
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Telephone | 918-592-2118
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Fax | 918-430-0118
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 10003
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License Number State | OK
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