Dr. Robert Kelvin Woodruff
Foot Surgery
3855 Azalea Drive
Jackson
, Mississippi 39206-5105
Dr. Robert Kelvin Woodruff
Foot Surgery
3855 Azalea Drive
Jackson
, Mississippi 39206-5105
(601) 506-7400
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About
Features
Specialties
- Foot Surgery
Languages spoken
- English
Location
First Address
- Dr. Robert Kelvin Woodruff
- 1055 Hubb Rd
- Bolton, MS
- Zip : 39041-8500
- Phone : (601) 506-7400
Second Address
- Dr. Robert Kelvin Woodruff
- 3855 Azalea Drive
- Jackson, MS
- Zip : 39206-5105
- Fax : (601) 366-7860
- Phone : (601) 366-7063
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 213ES0131X | Foot Surgery | 80102 | MS |
National Provider Identifier
| NPI | 1336220177 |
|---|---|
| Provider Name | Dr. Robert Kelvin Woodruff |
| First Address | Bolton, MS 39041-8500 |
| Second Address | Jackson, MS 39206-5105 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 18/10/2006 |
| Last Update Date | 10/09/2021 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 0010072 | (05) | MS |
| UO6301 | (02) | MS |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.