Provider Demographics
NPI:1972682664
Name:WOODSON, LINDA STEPHENS (MD)
Entity Type:Individual
Prefix:DR
First Name:LINDA
Middle Name:STEPHENS
Last Name:WOODSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:2800 N TENAYA WAY STE 203
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89128-1100
Mailing Address - Country:US
Mailing Address - Phone:702-202-2700
Mailing Address - Fax:702-307-5480
Practice Address - Street 1:2800 N TENAYA WAY STE 203
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89128-1100
Practice Address - Country:US
Practice Address - Phone:702-202-2700
Practice Address - Fax:702-307-5480
Is Sole Proprietor?:No
Enumeration Date:2006-11-03
Last Update Date:2015-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV7012207N00000X
CAG072603207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVGX609AMedicare UPIN