Provider Demographics
NPI:1376794156
Name:WOODRUFF, JILLIAN MARIE (MD)
Entity Type:Individual
Prefix:DR
First Name:JILLIAN
Middle Name:MARIE
Last Name:WOODRUFF
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 1:3851 PIPER ST STE U464
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99508-6905
Mailing Address - Country:US
Mailing Address - Phone:907-339-0363
Mailing Address - Fax:907-339-2363
Practice Address - Street 1:3851 PIPER ST STE U471
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-6905
Practice Address - Country:US
Practice Address - Phone:907-339-0363
Practice Address - Fax:907-339-2363
Is Sole Proprietor?:No
Enumeration Date:2008-10-10
Last Update Date:2023-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101248984207V00000X
AK100764207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AK1632651Medicaid