Individual
DENNIS D WOODHALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
525 WESTERN AVE, SUITE 302, CONWAY, AR 72034-4967
(501) 328-5515
Mailing address
525 WESTERN AVE, SUITE 302, CONWAY, AR 72034-4967
(501) 328-5515
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
28459
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
060071334
RAILROAD MEDICARE
WI
01
—
13420
DEAN
WI
05
—
30807900
—
WI
01
—
390807236A7
UNITY
WI
01
—
WI01P6
JOHN DEERE
WI
Enumeration date
11/22/2005
Last updated
04/19/2012
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