Provider Demographics
NPI:1093706061
Name:WOODS, SCOTT E (MD)
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:E
Last Name:WOODS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4411 MONTGOMERY RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45212-3187
Mailing Address - Country:US
Mailing Address - Phone:513-977-6700
Mailing Address - Fax:513-531-2624
Practice Address - Street 1:4411 MONTGOMERY RD
Practice Address - Street 2:SUITE 200
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45212-3187
Practice Address - Country:US
Practice Address - Phone:513-977-6700
Practice Address - Fax:513-531-2624
Is Sole Proprietor?:No
Enumeration Date:2005-10-31
Last Update Date:2011-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35057182207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200837740Medicaid
OH2181795Medicaid
KY64071491Medicaid
OH2181795Medicaid
OHP0005962Medicare PIN
OH0876211Medicare PIN
F08808Medicare UPIN