MEDICARE: DR. SCOTT BRIAN WOODY DO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	39735	CO

General Provider Information

NPI Number	:	1033117957
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SCOTT BRIAN WOODY DO

Provider Business Mailing Address
First Line	:	PO BOX 820
Second Line	:
City	:	CASTLE ROCK
State	:	CO
Zip	:	80104-0820
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	8301 E PRENTICE AVE
Second Line	:	SUITE 145
City	:	GREENWOOD VILLAGE
State	:	CO
Zip	:	80111-2903
Country	:	US
Telephone Number	:	303-469-7300
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/13/2005
Last Update Date	:	06/28/2012

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