MEDICARE: HAL B WOODALL MD

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	207R00000X	Internal Medicine Physician	20222	NC

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	110034167	OTHER	NC	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	89096	OTHER	NC	BC

General Provider Information

NPI Number	:	1235179128
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HAL B WOODALL MD

Provider Business Mailing Address
First Line	:	PO BOX 275
Second Line	:
City	:	KENLY
State	:	NC
Zip	:	27542-0275
Country	:	US
Telephone Number	:	919-284-4025
Fax Number	:	919-284-5965

Provider Business Practice Location Address
First Line	:	101 E 2ND ST
Second Line	:
City	:	KENLY
State	:	NC
Zip	:	27542-7794
Country	:	US
Telephone Number	:	919-284-4025
Fax Number	:	919-284-5965

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

Provider Enumeration Date	:	06/08/2006
Last Update Date	:	03/18/2015

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Directions to “ HAL B WOODALL MD” Practice Location

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