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General NPI Number Information
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NPI Number | 1477583714
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Entity Type | Individual
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Provider Name | MATTHEW M WOOSLEY MD
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Gender | Male
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Dates
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Enumeration Date | 07/03/2006
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Last Update Date | 12/21/2021
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Provider Practice Location Address
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Address Line | 645 E MISSOURI AVE STE 300
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City | PHOENIX
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State | AZ
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Zip | 85012-1351
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Country | US
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Telephone | 602-273-9333
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Fax | 480-609-9350
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Provider Business Mailing Address
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Address Line | 645 E MISSOURI AVE STE 300
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City | PHOENIX
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State | AZ
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Zip | 85012-1351
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Country | US
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Telephone | 602-273-9333
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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 | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 34963
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License Number State | AZ
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