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NPI 1477558724

NPI 1477558724 : GREGORY L WOODFILL DO : TWO RIVERS, WI

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General NPI Number Information
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    NPI Number           |    1477558724
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    Entity Type          |    Individual 
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    Provider Name        |    GREGORY L WOODFILL DO
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    06/14/2005
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    Last Update Date     |    07/28/2025
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Provider Practice Location Address
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    Address Line         |    5300 MEMORIAL DR 
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    City                 |    TWO RIVERS
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    State                |    WI
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    Zip                  |    54241-3923
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    Country              |    US
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    Telephone            |    920-793-7300
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    Fax                  |    920-793-7391
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Provider Business Mailing Address
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    Address Line         |    PO BOX 735044 
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    City                 |    CHICAGO
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    State                |    IL
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    Zip                  |    60673-5044
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    Country              |    US
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    Telephone            |    800-326-2250
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    Fax                  |    
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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        |    207V00000X
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    Taxonomy Name        |    Obstetrics & Gynecology Physician
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    License Number       |    22616
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    License Number State |    WI
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Taxonomy #2
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    Taxonomy Code        |    207V00000X
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    Taxonomy Name        |    Obstetrics & Gynecology Physician
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    License Number       |    2008-01845
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    License Number State |    NC
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