Provider Demographics
NPI:1306873815
Name:WOODRUM, GEORGE ORRIS (MD)
Entity type:Individual
Prefix:
First Name:GEORGE
Middle Name:ORRIS
Last Name:WOODRUM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:169 MITCHELL LN
Mailing Address - Street 2:
Mailing Address - City:STAUNTON
Mailing Address - State:VA
Mailing Address - Zip Code:24401-5593
Mailing Address - Country:US
Mailing Address - Phone:540-887-9690
Mailing Address - Fax:
Practice Address - Street 1:AUGUSTA MEDICAL CENTER ANESTHESIA DEPT
Practice Address - Street 2:78 MEDICAL CENTER DRIVE
Practice Address - City:FISHERSVILLE
Practice Address - State:VA
Practice Address - Zip Code:22939
Practice Address - Country:US
Practice Address - Phone:540-332-4326
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2014-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA046346207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA005762332Medicaid
VAE93579Medicare UPIN
VA050000684Medicare PIN