Provider Demographics
NPI:1780627232
Name:WOODS, BRONWYN (MD)
Entity type:Individual
Prefix:DR
First Name:BRONWYN
Middle Name:
Last Name:WOODS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5300 N INDEPENDENCE AVE
Mailing Address - Street 2:SUITE 280
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73112-5556
Mailing Address - Country:US
Mailing Address - Phone:405-713-7422
Mailing Address - Fax:405-713-7436
Practice Address - Street 1:3330 NW 56TH ST
Practice Address - Street 2:SUITE 220
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73112-4479
Practice Address - Country:US
Practice Address - Phone:405-713-7422
Practice Address - Fax:405-713-7436
Is Sole Proprietor?:No
Enumeration Date:2006-06-13
Last Update Date:2017-07-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OK23263207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OKH89336Medicare UPIN
OK900522214Medicare ID - Type UnspecifiedMEDICARE GROUP NUMBER
OKH89336Medicare UPIN