Individual
DR. SUSAN ALEXANDRIA WOODY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
1911 S NATIONAL AVE, SUITE 301, SPRINGFIELD, MO 65804-2219
(417) 886-5000
(417) 886-1100
Mailing address
1911 S NATIONAL AVE, SUITE 301, SPRINGFIELD, MO 65804-2219
(417) 886-5000
(417) 886-1100
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
112946
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
005012599
MEDICARE PTAN
MO
05
—
150376003
—
AR
01
—
163193
BLUE CROSS BLUE SHIELD
MO
05
—
243850716
—
MO
01
—
390008238
RAILROAD MEDICARE
MO
01
—
405634
HEALTHLINK PROVIDER
MO
Enumeration date
10/06/2006
Last updated
12/01/2009
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