Provider Demographics
NPI:1417032616
Name:WOODARD, RICHARD BLAIR (OD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:BLAIR
Last Name:WOODARD
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:610 JONES FERRY RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:CARRBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27510-6113
Mailing Address - Country:US
Mailing Address - Phone:919-929-1600
Mailing Address - Fax:
Practice Address - Street 1:610 JONES FERRY RD
Practice Address - Street 2:SUITE 200
Practice Address - City:CARRBORO
Practice Address - State:NC
Practice Address - Zip Code:27510-6113
Practice Address - Country:US
Practice Address - Phone:919-929-1600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1303152WV0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WV0400XEye and Vision Services ProvidersOptometristVision Therapy