Provider Demographics
NPI:1003146770
Name:H DARRELL WOODS, M.D. P.C.
Entity Type:Organization
Organization Name:H DARRELL WOODS, M.D. P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HYRUM
Authorized Official - Middle Name:DARRELL
Authorized Official - Last Name:WOODS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:801-387-4490
Mailing Address - Street 1:4403 HARRISON BLVD
Mailing Address - Street 2:SUITE 4440
Mailing Address - City:OGDEN
Mailing Address - State:UT
Mailing Address - Zip Code:84403-3271
Mailing Address - Country:US
Mailing Address - Phone:801-387-4490
Mailing Address - Fax:801-387-4499
Practice Address - Street 1:4403 HARRISON BLVD
Practice Address - Street 2:SUITE 4440
Practice Address - City:OGDEN
Practice Address - State:UT
Practice Address - Zip Code:84403-3271
Practice Address - Country:US
Practice Address - Phone:801-387-4490
Practice Address - Fax:801-387-4499
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-02
Last Update Date:2010-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT149661-1205207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT000012401Medicare PIN