Provider Demographics
NPI:1215260260
Name:WOODARD, ELIZABETH DOROTHY (MD,MPH)
Entity type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:DOROTHY
Last Name:WOODARD
Suffix:
Gender:F
Credentials:MD,MPH
Other - Prefix:MISS
Other - First Name:ELIZABETH
Other - Middle Name:DOROTHY
Other - Last Name:VANDERPOOL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:200 RIDGE RD W
Mailing Address - Street 2:KODAK MEDICAL DEPARTMENT
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14652-3402
Mailing Address - Country:US
Mailing Address - Phone:585-722-5703
Mailing Address - Fax:
Practice Address - Street 1:200 RIDGE RD W
Practice Address - Street 2:KODAK MEDICAL DEPARTMENT
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14652-3402
Practice Address - Country:US
Practice Address - Phone:585-722-5703
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-09
Last Update Date:2009-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY104718-12083P0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine