Provider Demographics
NPI:1316093545
Name:WOODWARD, JOHN T (DC)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:T
Last Name:WOODWARD
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1536 KIRKWOOD HWY
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19711-5716
Mailing Address - Country:US
Mailing Address - Phone:302-454-1200
Mailing Address - Fax:302-454-1238
Practice Address - Street 1:2036 FOULK RD
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19810-3648
Practice Address - Country:US
Practice Address - Phone:302-475-4200
Practice Address - Fax:302-475-4201
Is Sole Proprietor?:No
Enumeration Date:2007-01-29
Last Update Date:2019-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC4755L111N00000X
NJ38MC00413500111N00000X
DEF1-0000941111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA045827Medicare ID - Type UnspecifiedOLD BCBS AND MEDICARE NU