Individual
DR. CONCHITA L WOODRUFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1245 S UTICA AVE, 3RD FLOOR, TULSA, OK 74104-4214
(918) 579-2229
(918) 579-2239
Mailing address
6600 S YALE AVE, STE 1200, TULSA, OK 74136-3361
(918) 488-6687
(918) 488-6098
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
23123
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0612509
CIGNA
OK
05
—
100224210C
—
OK
01
—
200302607
TAX ID
OK
05
—
20087640A
—
OK
01
—
244534202
MEDICARE PIN #
OK
01
—
OKA105880
MEDICARE PTAN
OK
Enumeration date
11/16/2006
Last updated
01/17/2019
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