MEDICARE: DR. TIMOTHY W WOODARD M.D.

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	2084P0800X	Psychiatry Physician	2014035368	MO

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

General Provider Information

NPI Number	:	1518051226
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TIMOTHY W WOODARD M.D.

Provider Business Mailing Address
First Line	:	1300 E BRADFORD PKWY
Second Line	:
City	:	SPRINGFIELD
State	:	MO
Zip	:	65804-4264
Country	:	US
Telephone Number	:	417-761-5000
Fax Number	:	417-761-5065

Provider Business Practice Location Address
First Line	:	3401 BERRYWOOD DR STE 300
Second Line	:
City	:	COLUMBIA
State	:	MO
Zip	:	65201-6515
Country	:	US
Telephone Number	:	573-777-8330
Fax Number	:	573-777-8390

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

Provider Enumeration Date	:	10/03/2006
Last Update Date	:	03/07/2023

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