Individual
DOUGLAS L WOOLLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
900 N ORANGE ST, STE 103, MISSOULA, MT 59802-2998
(406) 728-1563
(406) 542-1037
Mailing address
900 N ORANGE ST, STE 103, MISSOULA, MT 59802-2998
(406) 728-1563
(406) 542-1037
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
4807
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0056321
—
MT
01
—
200045483 CK5082
RAILROAD MEDICARE
—
Enumeration date
10/26/2006
Last updated
07/08/2007
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