MEDICARE: LON D WOODS 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	174400000X	Specialist	MD031565E	PA

General Provider Information

NPI Number	:	1598764748
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LON D WOODS MD

Provider Business Mailing Address
First Line	:	455 S WASHINGTON ST
Second Line	:	STE 16
City	:	GETTYSBURG
State	:	PA
Zip	:	17325-2516
Country	:	US
Telephone Number	:	717-334-7609
Fax Number	:	717-334-7698

Provider Business Practice Location Address
First Line	:	455 S WASHINGTON ST
Second Line	:	STE 16
City	:	GETTYSBURG
State	:	PA
Zip	:	17325-2516
Country	:	US
Telephone Number	:	717-334-7609
Fax Number	:	717-334-7698

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

Provider Enumeration Date	:	07/19/2005
Last Update Date	:	07/08/2007

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