Provider Demographics
NPI:1528050564
Name:WOODWARD, HAROLD JACKSON JR (MD)
Entity type:Individual
Prefix:
First Name:HAROLD
Middle Name:JACKSON
Last Name:WOODWARD
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:2201 MCKOWN DR
Mailing Address - Street 2:#1
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73072-6682
Mailing Address - Country:US
Mailing Address - Phone:405-329-5613
Mailing Address - Fax:405-360-7747
Practice Address - Street 1:2201 MCKOWN DR
Practice Address - Street 2:#1
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73072-6682
Practice Address - Country:US
Practice Address - Phone:405-329-5613
Practice Address - Fax:405-360-7747
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-16
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OK8810207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
730965206001OtherBLUE CROSS
E11052Medicare UPIN