Provider Demographics
NPI:1124156526
Name:WOODALL, HAYLEY LYNN (OD)
Entity type:Individual
Prefix:DR
First Name:HAYLEY
Middle Name:LYNN
Last Name:WOODALL
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2104 SPRING VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17601-2427
Mailing Address - Country:US
Mailing Address - Phone:717-541-9700
Mailing Address - Fax:
Practice Address - Street 1:2104 SPRING VALLEY RD
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17601-2427
Practice Address - Country:US
Practice Address - Phone:717-541-9700
Practice Address - Fax:717-947-7997
Is Sole Proprietor?:No
Enumeration Date:2007-02-28
Last Update Date:2020-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS803152W00000X
TN2689152W00000X
PAOEG001874152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist