Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208800000X | Urologist | MD26728 | OR |
NPI | 1063572238 |
---|---|
Provider Name | Jeffrey B Woolsey |
First Address | Springfield, OR 97477-1118 |
Second Address | Springfield, OR 97477-1118 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/12/2006 |
Last Update Date | 01/05/2013 |