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General NPI Number Information
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NPI Number | 1316944283
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Entity Type | Organization
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Legal Business Name | JONATHAN H WOODCOCK MD & ASSOC PC
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Dates
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Enumeration Date | 07/07/2005
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Last Update Date | 02/17/2010
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Provider Practice Location Address
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Address Line | 8515 PEARL ST 203
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City | THORNTON
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State | CO
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Zip | 80229-4809
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Country | US
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Telephone | 303-288-7882
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Fax | 303-288-7874
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Provider Business Mailing Address
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Address Line | 8515 PEARL ST 203
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City | THORNTON
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State | CO
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Zip | 80229-4809
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Country | US
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Telephone | 303-288-7882
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Fax | 303-288-7874
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Authorized Official
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Title or Position | PRESIDENT
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Name | JONATHAN HUGH WOODCOCK
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Credential | M.D.
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Telephone | 303-288-7882
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 29436
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 29436
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License Number State | CO
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