Individual
DR. KELLY H WOODWARD I
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O., M.P.H.
Contact information
Practice address
5532 LILLEHAMMER LN STE 102, PARK CITY, UT 84098-6078
(435) 659-7633
(971) 397-0394
Mailing address
7165 CANYON DR, PARK CITY, UT 84098-5382
(703) 907-9716
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
9693614-1204
UT
2083P0901X
Public Health & General Preventive Medicine Physician
Primary
9693614-1204
UT
Other
Enumeration date
11/22/2005
Last updated
07/09/2025
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