Individual
JOHN WILLIAM WOODWARD II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
111 KILSON DR STE 201, MOORESVILLE, NC 28117-8218
(704) 663-2091
Mailing address
200 CORPORATE BLVD, LAFAYETTE, LA 70508-3870
(800) 893-9698
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
2013-01023
NC
207Q00000X
Family Medicine Physician
Primary
036119343
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036119343
—
IL
05
—
0361193431
—
IL
05
—
0361193439
—
IL
01
—
36119343
BCBS
IL
01
—
P00936475
RRMCARE THRU CESIISC (GES)
IL
Enumeration date
05/15/2007
Last updated
07/21/2022
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