Individual
STACY WOODARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
325 GEORGIA AVE STE 100, NORTH AUGUSTA, SC 29841-3848
(803) 202-3351
(803) 819-8532
Mailing address
PO BOX 1705, AUGUSTA, GA 30903-1705
(706) 774-7263
(706) 774-7230
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
8443
GA
Other
Enumeration date
08/19/2017
Last updated
01/04/2022
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