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General NPI Number Information
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NPI Number | 1417145392
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Entity Type | Individual
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Provider Name | DAWN ANDREA WOODROOF MD
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Gender | Female
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Dates
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Enumeration Date | 10/04/2007
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Last Update Date | 08/10/2012
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Provider Practice Location Address
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Address Line | 38 JOE T PETTY DRIVE
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City | RUSSELL SPRINGS
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State | KY
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Zip | 42642-8553
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Country | US
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Telephone | 606-658-9535
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Fax | 270-266-4189
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Provider Business Mailing Address
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Address Line | PO BOX 1430
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City | FRANKFORT
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State | KY
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Zip | 40602-1430
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Country | US
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Telephone | 502-226-3858
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Fax | 502-227-5081
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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 | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | A84696
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License Number State | CA
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