Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YP0228X | Pediatric Otolaryngology | 31155 | OK |
NPI | 1013241470 |
---|---|
Provider Name | Dr. Elena Beth Woodson |
First Address | Oklahoma City, OK 73114-6323 |
Second Address | Oklahoma City, OK 73114-6323 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/10/2009 |
Last Update Date | 06/08/2020 |