Individual
DR. ROBERT KELVIN WOODRUFF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.P.M., P.A.
Contact information
Practice address
3855 AZALEA DRIVE, JACKSON, MS 39206-5105
(601) 366-7063
(601) 366-7860
Mailing address
1055 HUBB RD, BOLTON, MS 39041-8500
(601) 506-7400
Taxonomy
Speciality
Code
Description
License number
State
213ES0131X
Foot Surgery Podiatrist
Primary
80102
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0010072
—
MS
Enumeration date
10/18/2006
Last updated
09/10/2021
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