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Individual
DR. BRENT GRAY WOODBURY
Active
Individual
DR. BRENT GRAY WOODBURY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
39649
IA
207X00000X
Orthopaedic Surgery Physician
94-06593
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1558412130
WELLMARK BLUE CROSS BLUE SHIELD
IA
05
—
1558412130
—
IA
Enumeration date
01/12/2007
Last updated
10/06/2011
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