Provider Demographics
NPI:1942807151
Name:WOODS, DARRELL O
Entity Type:Individual
Prefix:
First Name:DARRELL
Middle Name:O
Last Name:WOODS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1403 METRO DR STE C1
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:LA
Mailing Address - Zip Code:71301-3446
Mailing Address - Country:US
Mailing Address - Phone:318-625-7467
Mailing Address - Fax:318-625-7420
Practice Address - Street 1:1403 METRO DR STE C1
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:LA
Practice Address - Zip Code:71301-3446
Practice Address - Country:US
Practice Address - Phone:318-625-7467
Practice Address - Fax:318-625-7420
Is Sole Proprietor?:No
Enumeration Date:2020-10-01
Last Update Date:2020-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator