Provider Demographics
NPI:1851436166
Name:WOODROOF, KERRY C (MD)
Entity Type:Individual
Prefix:
First Name:KERRY
Middle Name:C
Last Name:WOODROOF
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:412 N BRIDGE ST STE 2
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:VA
Mailing Address - Zip Code:24523-1981
Mailing Address - Country:US
Mailing Address - Phone:540-586-1774
Mailing Address - Fax:540-586-1774
Practice Address - Street 1:412 N BRIDGE ST STE 2
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:VA
Practice Address - Zip Code:24523-1981
Practice Address - Country:US
Practice Address - Phone:540-586-1774
Practice Address - Fax:540-586-1774
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-21
Last Update Date:2013-07-09
Deactivation Date:2012-01-12
Deactivation Code:
Reactivation Date:2013-07-02
Provider Licenses
StateLicense IDTaxonomies
VA0101031448207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology