Individual
BRETT L WOODFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
—
—
363AM0700X
Medical Physician Assistant
—
—
363AS0400X
Surgical Physician Assistant
Primary
6881
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003136301P
—
GA
05
—
003136301Q
—
GA
05
—
003136301R
—
GA
05
—
003136301S
—
GA
05
—
003136301T
—
GA
05
—
003136301U
—
GA
05
—
003136301V
—
GA
Enumeration date
06/21/2013
Last updated
11/14/2024
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