Provider Demographics
NPI:1740543065
Name:WOODS, WILLIAM J (RPH)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:J
Last Name:WOODS
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4465 WHITE TAIL CT
Mailing Address - Street 2:
Mailing Address - City:NASHPORT
Mailing Address - State:OH
Mailing Address - Zip Code:43830-9297
Mailing Address - Country:US
Mailing Address - Phone:740-455-2659
Mailing Address - Fax:
Practice Address - Street 1:1208 MAPLE AVE
Practice Address - Street 2:
Practice Address - City:ZANESVILLE
Practice Address - State:OH
Practice Address - Zip Code:43701-2850
Practice Address - Country:US
Practice Address - Phone:740-453-3442
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-21
Last Update Date:2012-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302026183183500000X
OH03116361183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist