Individual
DR. CHARLES E. WOODALL JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
18598 HIGHWAY 13 NORTH, BRANSON WEST, MO 65616
(417) 272-8497
(417) 272-8496
Mailing address
PO BOX 2580, SPRINGFIELD, MO 65801-2580
(417) 829-4620
(417) 829-4316
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
R2D64
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
241848100
—
MO
Enumeration date
10/20/2006
Last updated
07/17/2008
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