Provider Demographics
NPI:1629026034
Name:WOODFORD, DIANE ETHEL (MD)
Entity Type:Individual
Prefix:DR
First Name:DIANE
Middle Name:ETHEL
Last Name:WOODFORD
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 1:8415 N PIMA RD STE 290
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85258-4488
Mailing Address - Country:US
Mailing Address - Phone:480-434-6565
Mailing Address - Fax:480-383-6426
Practice Address - Street 1:8415 N PIMA RD STE 290
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85258
Practice Address - Country:US
Practice Address - Phone:480-434-6565
Practice Address - Fax:480-383-6426
Is Sole Proprietor?:No
Enumeration Date:2006-05-05
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD000046352207VE0102X
AZ54327207VE0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VE0102XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyReproductive Endocrinology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KYH86951Medicare UPIN