MEDICARE: DR. PAUL K WOODWARD DPM

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	213E00000X	Podiatrist	AZ0232	AZ

General Provider Information

NPI Number	:	1265428064
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PAUL K WOODWARD DPM

Provider Business Mailing Address
First Line	:	3832 E THOMAS RD
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85018-7510
Country	:	US
Telephone Number	:	602-955-2030
Fax Number	:	602-955-7096

Provider Business Practice Location Address
First Line	:	3832 E THOMAS RD
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85018-7510
Country	:	US
Telephone Number	:	602-955-2030
Fax Number	:	602-955-7096

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

Provider Enumeration Date	:	09/27/2005
Last Update Date	:	08/14/2012

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