Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207P00000X | Emergency Physician | 029974 | GA |
N | 207Q00000X | Family Doctor | 29974 | GA |
Y | 207Q00000X | Family Doctor | OS11952 | FL |
N | 207QG0300X | Family Doctor - Geriatric Medicine | OS11952 | FL |
NPI | 1013956572 |
---|---|
Provider Name | Dr. William Alan Woolery |
First Address | Panama City Beach, FL 32413 |
Second Address | Panama City Beach, FL 32413 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/06/2006 |
Last Update Date | 25/10/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00369091A | (05) | GA |
D31446 | (02) | GA |