Provider Demographics
NPI:1326383092
Name:WOODWARD HEALTH SYSTEM LLC
Entity Type:Organization
Organization Name:WOODWARD HEALTH SYSTEM LLC
Other - Org Name:WOODWARD CLINICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP PHYSICIAN OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:A
Authorized Official - Last Name:PEOPLES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-465-7585
Mailing Address - Street 1:PO BOX 689022
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37068-9022
Mailing Address - Country:US
Mailing Address - Phone:800-709-7338
Mailing Address - Fax:615-465-3007
Practice Address - Street 1:1818 KANSAS AVE
Practice Address - Street 2:
Practice Address - City:WOODWARD
Practice Address - State:OK
Practice Address - Zip Code:73801-2912
Practice Address - Country:US
Practice Address - Phone:580-254-3396
Practice Address - Fax:580-254-5311
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WOODWARD HEALTH SYSTEM LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-12-06
Last Update Date:2013-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty