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Individual
TODD A. WOOLLEN
Active
Individual
TODD A. WOOLLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
21191
NE
207Q00000X
Family Medicine Physician
34701
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0270801
—
IA
01
—
30555
WELLMARK BC/BS
IA
Enumeration date
08/12/2005
Last updated
08/16/2022
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