Provider Demographics
NPI:1477507564
Name:WOODS, MARK S (MD)
Entity type:Individual
Prefix:DR
First Name:MARK
Middle Name:S
Last Name:WOODS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:915 13TH AVE N
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:IA
Mailing Address - Zip Code:52732-5067
Mailing Address - Country:US
Mailing Address - Phone:563-243-2511
Mailing Address - Fax:563-243-0817
Practice Address - Street 1:635 E LINCOLNWAY
Practice Address - Street 2:
Practice Address - City:MORRISON
Practice Address - State:IL
Practice Address - Zip Code:61270-2963
Practice Address - Country:US
Practice Address - Phone:815-772-7491
Practice Address - Fax:812-772-7891
Is Sole Proprietor?:No
Enumeration Date:2006-05-22
Last Update Date:2013-03-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IA24262207Q00000X
IL036-072976207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL0029840095OtherILLINOIS BCBS
IL036072976Medicaid
27172OtherIOWA HEALTH SOLUTIONS
IA0018036Medicaid
IA20814OtherWELLMARK BC/BS
IL09822166OtherBC/BS ILLINOIS
19360OtherMIDLANDS CHOICE
IA0120OtherJOHN DEERE HEALTH
018405OtherHEALTH ALLIANCE
C44127Medicare UPIN
27172OtherIOWA HEALTH SOLUTIONS
018405OtherHEALTH ALLIANCE
IA0120OtherJOHN DEERE HEALTH
IL09822166OtherBC/BS ILLINOIS