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NPI Code Detail

MEDICARE: DR. HAYLEY M WOODRUFF OD

MEDICARE: DR. HAYLEY M WOODRUFF OD
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
1152W00000XOptometrist1614DTKY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1073609111
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. HAYLEY M WOODRUFF OD
Provider Business Mailing Address
First Line : 1536 STORY AVE
Second Line : THE EYE CARE INSTITUTE BUILDING
City : LOUISVILLE
State : KY
Zip : 40206-1738
Country : US
Telephone Number : 502-589-1500
Fax Number : 502-589-1556
Provider Business Practice Location Address
First Line : 1536 STORY AVE
Second Line : THE EYE CARE INSTITUTE BUILDING
City : LOUISVILLE
State : KY
Zip : 40206-1738
Country : US
Telephone Number : 502-589-1500
Fax Number : 502-589-1556
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/05/2006
Last Update Date : 07/08/2007

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