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Individual

RONALD S WOODWORTH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
140 HOSPITAL DR, SUITE 300, BENNINGTON, VT 05201-5009
(802) 447-1564
(802) 447-3346
Mailing address
140 HOSPITAL DR STE 300, PO BOX 1432, BENNINGTON, VT 05201-5018
(802) 447-1564
(802) 447-3346

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0320000265
VT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0005198
VT
01
5198
BCBS VT
VT
Enumeration date
05/30/2006
Last updated
07/08/2007
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