Provider Demographics
NPI:1013192442
Name:WOODRIFFE, RAMONA BEATRICE (MD)
Entity Type:Individual
Prefix:DR
First Name:RAMONA
Middle Name:BEATRICE
Last Name:WOODRIFFE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MRS
Other - First Name:RAMONA
Other - Middle Name:BEATRICE
Other - Last Name:KAYE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:4824 E BASELINE RD
Mailing Address - Street 2:SUITE 110
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85206
Mailing Address - Country:US
Mailing Address - Phone:480-969-4040
Mailing Address - Fax:480-830-1042
Practice Address - Street 1:4824 E BASELINE RD
Practice Address - Street 2:SUITE 110
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85206
Practice Address - Country:US
Practice Address - Phone:480-969-4040
Practice Address - Fax:480-830-1042
Is Sole Proprietor?:No
Enumeration Date:2008-01-03
Last Update Date:2011-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ12825207P00000X, 207Q00000X
PAMD021106E207P00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ283177OtherARIZONA AHCCCS ID
AZD88982Medicare UPIN
AZZ120766Medicare PIN