Woodall, Timothy Marvin

Woodall, Timothy Marvin is an individual health care provider with primary practice located at 4370 W Main St , Dothan AL 36305. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as his primary health care specialty. Woodall, Timothy Marvin can be contacted via phone (334) 793-5000.

Contact Information

Primary practice address
4370 W Main St Dothan AL 36305
Phone: (334) 793-5000
Fax: (334) 615-8419
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 1037973 Alabama

Profile Details

NPI number 1609837400
LBN Legal business name Woodall, Timothy Marvin
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 31st, 2006
Last updated Jul 8th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1609837400 NPPES
Louisiana MEDICAID 1772429
Louisiana Other 51515684
Louisiana MEDICAID 08028075
Louisiana Other P00122063

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