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General NPI Number Information
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NPI Number | 1407266695
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Entity Type | Individual
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Provider Name | PAUL RICHARD WOODARD II M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/28/2014
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Last Update Date | 05/19/2021
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Provider Practice Location Address
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Address Line | 101 CLINIC DR
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City | TARBORO
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State | NC
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Zip | 27886
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Country | US
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Telephone | 252-824-5061
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Fax | 252-824-5011
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Provider Business Mailing Address
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Address Line | 101 CLINIC DR
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City | TARBORO
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State | NC
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Zip | 27886-1935
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Country | US
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Telephone | 528-245-0352
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Fax | 252-824-5011
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 2017-02111
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License Number State | NC
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