# WOODRUFF FAMILY MEDICAL CLINIC, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1235570938
- **Authorized official:** DR. ROBERT A. WOODRUFF D.O. (OWNER/PHYSICIAN)
- **Authorized official phone:** (918) 465-0001

## Contact information

- **Practice address:** 311 W MAIN ST, WILBURTON, OK 74578-4047
- **Practice address phone:** (918) 465-0001
- **Practice address fax:** (918) 465-0003
- **Mailing address:** 311 W MAIN ST, WILBURTON, OK 74578-4047
- **Mailing address phone:** (918) 465-0001
- **Mailing address fax:** (918) 465-0003

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 2209 | OK | Yes |

## Other

- **Enumeration date:** 07/10/2013
- **Last updated:** 03/17/2014