Organization
ASSOCIATED DERMATOLOGY, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOSEPH CORDER WOOFTER M.D.F.A.A.D (OWNER/PHYSICIAN)
(304) 485-3834
Entity
Organization
Contact information
Practice address
1110 20TH ST, PARKERSBURG, WV 26101-2609
(304) 485-3834
(304) 422-4911
Mailing address
1110 20TH ST., PARKERSBURG, WV 26101
(304) 485-3834
(304) 422-4911
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
09476
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1780648287
NPI INDIVIDUAL #
—
01
—
AS9264011
MEDICARE GROUP ID#
WV
01
—
W00368442
MEDICARE INDIVIDUAL #
WV
Enumeration date
11/27/2007
Last updated
11/27/2007
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