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General NPI Number Information
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NPI Number | 1851514947
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Entity Type | Organization
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Legal Business Name | NANCY K. WOODRUFF, MD, PC
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Dates
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Enumeration Date | 04/10/2007
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Last Update Date | 03/20/2008
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Provider Practice Location Address
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Address Line | 108 SE AVE N
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City | IDABEL
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State | OK
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Zip | 74745-1228
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Country | US
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Telephone | 580-286-4343
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1228
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City | IDABEL
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State | OK
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Zip | 74745-1228
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Country | US
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Telephone | 580-286-4343
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN
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Name | NANCY K WOODRUFF
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Credential | MD
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Telephone | 580-286-4343
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 18230
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License Number State | OK
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