Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VG0400X | Gynecologist | R3797 | AR |
NPI | 1194751164 |
---|---|
Provider Name | Dr. Elizabeth Ann Woods |
First Address | Fayetteville, AR 72701-3110 |
Second Address | Fayetteville, AR 72701-3110 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/06/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
12315 | QUALCHOICE INS. PROV. ID (01) | AR |
C68400 | (02) | AR |