Physician Compare National (NPI:1942462403)

HEALTHCARE PROVIDER: JEREMY DUSTIN WOODWARD PT, DPT, MS

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1942462403
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	1557429529
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20081020000384
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	WOODWARD
	Individual professional last name
Provider First Name	JEREMY
	Individual professional first name
Provider Middle Name	D
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	2008
	Individual professional's medical school graduation year
Primary Specialty	PHYSICAL THERAPY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	127 ALBEN BARKLEY DR
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE C
	Group Practice or individual's line 2 address
City	PADUCAH
	Group Practice or individual's city
State	KY
	Group Practice or individual's state
Zip Code	420014402
	Group Practice or individual's zip code (9 digits when available)
Phone Number	2709080294
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	M