Provider Demographics
NPI:1306842489
Name:WOODS, TIMOTHY WAYNE (MD)
Entity Type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:WAYNE
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 1:1200 WESTWOOD DR
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:MT
Mailing Address - Zip Code:59840-2345
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1200 WESTWOOD DR
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:MT
Practice Address - Zip Code:59840-2345
Practice Address - Country:US
Practice Address - Phone:406-375-4868
Practice Address - Fax:406-375-4655
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-23
Last Update Date:2021-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDM-9236207X00000X
MT34007207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT1306842489Medicaid
WA1306842489Medicaid
ID76961OtherBLUE CROSS
ID313071OtherALTIUS
ID807083500Medicaid
ID1306842489Medicaid
ID000010149378OtherREGENCE BLUE SHIELD
ID11296451Medicare PIN
ID1129645Medicare PIN
ID313071OtherALTIUS
G43574Medicare UPIN
IDP00458525Medicare PIN
IDP00279845Medicare PIN