Provider Demographics
NPI:1609132489
Name:LARRY H. WOODCOX DPM APC
Entity Type:Organization
Organization Name:LARRY H. WOODCOX DPM APC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LARRY
Authorized Official - Middle Name:HOWARD
Authorized Official - Last Name:WOODCOX
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:510-251-0330
Mailing Address - Street 1:1624 FRANKLIN ST. #510
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94612-2823
Mailing Address - Country:US
Mailing Address - Phone:510-251-0330
Mailing Address - Fax:510-251-0344
Practice Address - Street 1:1624 FRANKLIN ST. STE 510
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94612-2823
Practice Address - Country:US
Practice Address - Phone:510-251-0330
Practice Address - Fax:510-251-0344
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-06
Last Update Date:2012-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE2031213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty