Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207P00000X | Emergency Physician | 0000002125 | TN |
N | 207PP0204X | Pediatric Emergency Physician | 0000002125 | TN |
Y | 207PP0204X | Pediatric Emergency Physician | DO.000167 | LA |
NPI | 1790979615 |
---|---|
Provider Name | Dr. Christopher James Woodward |
First Address | Baton Rouge, LA 70816-6038 |
Second Address | Baton Rouge, LA 70809-3489 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/09/2007 |
Last Update Date | 21/05/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
07177760 | (05) | MS |
1007749 | (05) | LA |
107749 | (05) | LA |