Individual
DR. MATTHEW J. WOODYARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
11477 OLIVE BLVD, CREVE COEUR, MO 63141-7108
(314) 567-3884
(800) 432-6004
Mailing address
211 E BROADWAY, ALTON, IL 62002-6220
(314) 567-3884
(800) 432-6004
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2003017104
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1295737294
GROUP NPI
MO
01
—
1366411969
INDIVIDUAL NPI
MO
05
—
1366411969
—
MO
01
—
179523
BLUE CROSS BLUE SHIELD MO
—
01
—
1962644732
GROUP NPI
MO
01
—
211205
COLE
—
01
—
26004
OPTICARE MED. COMPLETE
—
05
—
319024600
—
MO
05
—
319024618
—
MO
01
—
45351
HEALTHCARE USA
MO
01
—
51675
DAVIS VISION
—
01
—
674993
HEALTHLINK
—
01
—
990301722
MEDICARE PART B
MO
01
—
MA2784
GROUP PTAN
MO
01
—
MO7104
EYEMED
—
01
—
P00403049
RR MEDICARE
MO
Enumeration date
03/16/2006
Last updated
12/19/2012
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