Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PE0004X | Emergency Medical Services | 0081268 | OH |
NPI | 1023676897 |
---|---|
Provider Name | Mr. Donald Ray Woodyard JR. |
First Address | Columbus, OH 43235-5087 |
Second Address | Columbus, OH 43235-5087 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/06/2019 |
Last Update Date | 05/06/2019 |