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Individual

GARY W WOODWARD

Active
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Individual

GARY W WOODWARD

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Taxonomy

Speciality
Code
Description
License number
State
207YX0905X
Otolaryngology/Facial Plastic Surgery Physician
Primary
R 4293
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
040012508
RAILROAD MEDICARE
AR
05
121667001
AR
01
55525
BCBS
AR
Enumeration date
02/22/2006
Last updated
05/01/2008
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