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General NPI Number Information
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NPI Number | 1730481557
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Entity Type | Organization
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Legal Business Name | MARK DOWNING WOODARD M.D. P.C.
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Dates
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Enumeration Date | 11/30/2010
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Last Update Date | 10/09/2011
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Provider Practice Location Address
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Address Line | 1320 BISHOP RANDALL DR
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City | LANDER
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State | WY
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Zip | 82520-3939
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Country | US
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Telephone | 307-335-6352
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Fax |
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Provider Business Mailing Address
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Address Line | 27 GANNETT PEAK DR
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City | LANDER
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State | WY
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Zip | 82520-9643
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Country | US
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Telephone | 307-332-3415
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MARK DOWNING WOODARD
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Credential | M.D.
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Telephone | 307-438-2729
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207ZP0105X
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Taxonomy Name | Clinical Pathology/Laboratory Medicine Physician
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License Number | 5662A
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License Number State | WY
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