Provider Demographics
NPI:1528066222
Name:WOODS, MARY FRANCES F (MD)
Entity type:Individual
Prefix:
First Name:MARY FRANCES
Middle Name:F
Last Name:WOODS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MARY-FRAN
Other - Middle Name:
Other - Last Name:WOODS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD, PA
Mailing Address - Street 1:2950 MAGIC VIEW DR.
Mailing Address - Street 2:STE 182
Mailing Address - City:MERIDIAN
Mailing Address - State:ID
Mailing Address - Zip Code:83642-3560
Mailing Address - Country:US
Mailing Address - Phone:208-884-0688
Mailing Address - Fax:208-884-0690
Practice Address - Street 1:2950 MAGIC VIEW DR.
Practice Address - Street 2:STE 182
Practice Address - City:MERIDIAN
Practice Address - State:ID
Practice Address - Zip Code:83642-3560
Practice Address - Country:US
Practice Address - Phone:208-884-0688
Practice Address - Fax:208-884-0690
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDM7284207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
E89506Medicare UPIN
1140786Medicare ID - Type Unspecified