Organization
LEE P.WOODRUFF DPM, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LEE P. WOODRUFF DPM (OWNER)
(870) 933-0041
Entity
Organization
Contact information
Practice address
1815 EXECUTIVE SQ, JONESBORO, AR 72401-6086
(870) 933-0041
(870) 933-0531
Mailing address
1815 EXECUTIVE SQ, JONESBORO, AR 72401-6086
(870) 933-0041
(870) 933-0531
Taxonomy
Speciality
Code
Description
License number
State
261QP1100X
Podiatric Clinic/Center
Primary
117
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
119031717
—
AR
Enumeration date
02/25/2010
Last updated
02/25/2010
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