Provider Demographics
NPI:1043229131
Name:WOODRING, CATHY (MD)
Entity Type:Individual
Prefix:
First Name:CATHY
Middle Name:
Last Name:WOODRING
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 8035
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67208-0035
Mailing Address - Country:US
Mailing Address - Phone:316-689-9135
Mailing Address - Fax:316-689-9102
Practice Address - Street 1:222 S RIDGE RD
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67209-2113
Practice Address - Country:US
Practice Address - Phone:316-945-0142
Practice Address - Fax:316-946-1798
Is Sole Proprietor?:No
Enumeration Date:2006-08-06
Last Update Date:2013-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS19662207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS000955OtherBCBS
KS16876OtherCOVENTRY
KS100212OtherHPK
KS100192260AMedicaid
KS1040OtherPHS
KS12149480OtherMULTIPLAN
KS000955Medicare ID - Type Unspecified
KS100192260AMedicaid