Provider Demographics
NPI:1295304103
Name:WOODY, JASON KORT SR (DO)
Entity type:Individual
Prefix:DR
First Name:JASON
Middle Name:KORT
Last Name:WOODY
Suffix:SR
Gender:M
Credentials:DO
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Mailing Address - Street 1:660 MASON RIDGE CENTER DR STE 300
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63141-8512
Mailing Address - Country:US
Mailing Address - Phone:314-448-3791
Mailing Address - Fax:314-966-9394
Practice Address - Street 1:1471 US HIGHWAY 61
Practice Address - Street 2:
Practice Address - City:FESTUS
Practice Address - State:MO
Practice Address - Zip Code:63028-4109
Practice Address - Country:US
Practice Address - Phone:636-937-2700
Practice Address - Fax:636-937-8666
Is Sole Proprietor?:No
Enumeration Date:2021-06-24
Last Update Date:2024-08-07
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Provider Licenses
StateLicense IDTaxonomies
MO2021024168207Q00000X
MO2024028667207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine