MEDICARE: DR. LINDA STEPHENS WOODSON 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	207N00000X	Dermatology Physician	7012	NV
2	207N00000X	Dermatology Physician	G072603	CA

General Provider Information

NPI Number	:	1972682664
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LINDA STEPHENS WOODSON M.D.

Provider Business Mailing Address
First Line	:	2800 N TENAYA WAY STE 203
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89128-1100
Country	:	US
Telephone Number	:	702-202-2700
Fax Number	:	702-307-5480

Provider Business Practice Location Address
First Line	:	2800 N TENAYA WAY STE 203
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89128-1100
Country	:	US
Telephone Number	:	702-202-2700
Fax Number	:	702-307-5480

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

Provider Enumeration Date	:	11/03/2006
Last Update Date	:	01/28/2015

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