Provider Demographics
NPI:1427268465
Name:MCCRADY, WOODROW (LMT)
Entity type:Individual
Prefix:
First Name:WOODROW
Middle Name:
Last Name:MCCRADY
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 129
Mailing Address - Street 2:
Mailing Address - City:BUCKHANNON
Mailing Address - State:WV
Mailing Address - Zip Code:26201-0129
Mailing Address - Country:US
Mailing Address - Phone:304-473-8988
Mailing Address - Fax:304-472-9849
Practice Address - Street 1:6250 GRAND CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:PARKERSBURG
Practice Address - State:WV
Practice Address - Zip Code:26105-8924
Practice Address - Country:US
Practice Address - Phone:304-473-8988
Practice Address - Fax:304-472-9849
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV2001-07012083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine