Organization
WOODRUFF FAMILY MEDICAL CLINIC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT A. WOODRUFF D.O. (OWNER/PHYSICIAN)
(918) 465-0001
Entity
Organization
Contact information
Practice address
311 W MAIN ST, WILBURTON, OK 74578-4047
(918) 465-0001
(918) 465-0003
Mailing address
311 W MAIN ST, WILBURTON, OK 74578-4047
(918) 465-0001
(918) 465-0003
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2209
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100749100A
—
OK
Enumeration date
07/10/2013
Last updated
03/17/2014
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