Individual
DR. RAY K. WOODMANSEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1102 WEST 32ND STREET, JOPLIN, MO 64804
(417) 347-1111
(417) 347-2149
Mailing address
1102 WEST 32ND STREET, JOPLIN, MO 64804
(417) 347-1111
(417) 347-2149
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
106089
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
024050147
MEDICARE
MO
01
—
204642102
MEDICAID
MO
05
—
243419306
—
MO
Enumeration date
05/26/2006
Last updated
05/13/2009
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