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Individual

TAIRA LYNN WOODROFFE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
4242 HIGHWAY 19, BUILDING 3 SUITE A, ZACHARY, LA 70791-3981
(225) 658-7860
(225) 658-7862
Mailing address
4242 HIGHWAY 19, BUILDING 3 SUITE A, ZACHARY, LA 70791-3981
(225) 658-7860
(225) 658-7862

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
25MA08812300
NJ
208000000X
Pediatrics Physician
Primary
MD 204357
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2152408
LA
Enumeration date
12/23/2008
Last updated
03/10/2016
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